Long-term trends and regional inequalities in epilepsy of genetic/unknown cause in Europe (1990-2023): A data analysis of the global burden of disease study.

Authors

Francesco Brigo, Simona Lattanzi, Eugen Trinka, Johan Zelano

Published in

Seizure. Volume 142. Pages 131-136. Aug 20, 2026. Epub Aug 20, 2026.

Abstract

In Global Burden of Disease (GBD) framework, idiopathic epilepsy corresponds to epilepsy of genetic/unknown cause, encompassing cases without identifiable etiologies. Despite major health-system changes across Europe, long-term, regionally disaggregated assessments of its burden remain limited.
Using GBD 2023 estimates, we analysed age-standardized Disability‑Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years Lived with Disability (YLD) rates for epilepsy of genetic/unknown cause across Central, Eastern, and Western Europe from 1990 to 2023. We applied log-linear models with cluster-robust inference, assessed linearity using polynomial terms, estimated annual percentage changes (EAPCs), evaluated sex- and area-specific differences through interaction models and Benjamini-Hochberg-adjusted pairwise contrasts, and decomposed long-term changes into mortality and disability components using Shapley-style averages.
The overall burden decreased across Europe, but temporal trends differed considerably between macroareas. Linearity checks supported a log-linear specification, and diagnostic analyses identified no influential observations. Sex-specific slopes did not differ significantly for any outcome, whereas strong heterogeneity emerged across macroareas: Eastern Europe showed the steepest declines, while Western Europe showed largely stable or less favourable trends. Area-year interactions showed evidence of heterogeneity, and pairwise contrasts confirmed robust differences. In decomposition analyses, YLL and YLD components contributed to reductions in DALYs.
The overall burden of epilepsy of genetic/unknown cause decreased across Europe from 1990 to 2023, but trends differed substantially between macroareas, with Eastern Europe experiencing the most rapid improvements. These findings provide a coherent epidemiological foundation for future research and policy aimed at reducing regional disparities in epilepsy outcomes.

PMID:
42691787
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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