Objective  To analyze the disease burden and trends of idiopathic epilepsy in China from 1990 to 2021, and to conduct predictive analysis.

Methods  Using the Global Burden of Disease Study 2021 database, of prevalence, mortality, disability-adjusted life years (DALYs), age-standardized rates, estimated annual percentage change (EAPC), and 95% CI of idiopathic epilepsy in China and globally were selected to evaluate the trend of disease burden. An age-period-cohort model was used to analyze the independent effects of age, period, and birth cohort, and an autoregressive integrated moving average (ARIMA) model was used to predict the disease burden trends from 2022 to 2031. The disease burden of idiopathic epilepsy was analyzed by different gender and age group, and compared with that of Parkinson's disease and Alzheimer's disease.

Results  In 2021, the number of idiopathic epilepsy cases in China was 3,086,300, with an age-standardized prevalence rate (ASPR) of 214.71/100,000; the number of deaths was 11,900, with an age-standardized mortality rate (ASMR) of 0.81/100,000; DALYs were 1,374,700 person-years, with an age-standardized DALYs rate (ASDR) of 101.39/100,000 person years. From 1990 to 2021, ASPR [EAPC=-0.32%, 95%CI (-0.56%, -0.07%)], ASMR [EAPC= -2.96%, 95%CI (-3.09%, -2.83%)], and ASDR [EAPC=-2.38%, 95%CI (-2.53%, -2.23%)] of idiopathic epilepsy in China all showed a downward trend. Males had higher prevalence, mortality, and DALY rates across all age groups than females, and the disease burden was heavier in young and middle-aged adults. The disease burden of Parkinson's disease and Alzheimer's disease was higher than that of idiopathic epilepsy. The age effect showed that the prevalence rate initially decreases and then increases with age, while mortality and DALY rates showed a continuous downward trend. The period effect showed that the risk of developing the disease initially increases and then decreases, while the risk of mortality and DALYs showed a continuous downward trend. The cohort effect showed that later-born cohorts has lower risks of prevalence, death, and DALYs. The ARIMA model predicted that by 2031, ASPR and ASDR will tend to be stable, while ASMR would continue to decline.

Conclusion  The disease burden of idiopathic epilepsy in China has shown a downward trend, with significant achievements in prevention and control; however, males and young and middle-aged adults remain the key focus of prevention and control efforts.

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