Objective:

Background:

Epilepsy remains one of the most common neurological disorders worldwide, particularly in low- and middle-income regions. Despite breakthroughs in therapy, information on long-term trends in idiopathic epilepsy in South Asia is scarce. Understanding these patterns is crucial for improving regional health policies and epilepsy treatment.

Design/Methods:

Data were obtained from the Global Burden of Disease (GBD) 2021 study. Age-standardized prevalence, incidence, death, disability-adjusted life years (DALYs), and years lived with disability (YLDs) for idiopathic epilepsy were extracted for South Asian countries from 1990 to 2021. Temporal trends were analyzed using the average annual percentage change (AAPC) with 95% confidence intervals (CI).

Results:

From 1990 to 2021, the number of people living with idiopathic epilepsy in South Asia rose from 2.71 million to 4.71 million, while the age-standardized prevalence rate remained stable (247.7 to 259.7 per 100,000; AAPC = –0.94%; p < 0.001). The incidence rate showed a slight increase (30.8 to 33.1 per 100,000; AAPC = 0.19%; p = 0.006). Mortality declined significantly from 3.56 to 2.58 per 100,000 (AAPC = –0.99%; p < 0.001). DALY rates fell by about 25% (266.3 → 199.2 per 100,000), and YLDs showed moderate reductions. Bangladesh and India exhibited the greatest declines in mortality and DALY rates. Males had slightly higher prevalence and incidence, while females in some countries showed higher mortality.

Conclusions:

Although idiopathic epilepsy remains a major neurological burden in South Asia, significant declines in mortality and disability suggest improved management and healthcare access. Continued efforts to improve diagnosis, treatment adherence, and equitable epilepsy care are crucial for sustaining progress and reducing regional disparities.