title: Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies.
abstract: OBJECTIVE
  To review population-based studies of the prevalence and incidence of epilepsy worldwide and use meta-analytic techniques to explore factors that may explain heterogeneity between estimates.
  
  
  METHODS
  The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed. We searched MEDLINE and EMBASE for articles published on the prevalence or incidence of epilepsy since 1985. Abstract, full-text review, and data abstraction were conducted in duplicate. Meta-analyses and meta-regressions were used to explore the association between prevalence or incidence, age group, sex, country level income, and study quality.
  
  
  RESULTS
  A total of 222 studies were included (197 on prevalence, 48 on incidence). The point prevalence of active epilepsy was 6.38 per 1,000 persons (95% confidence interval [95% CI] 5.57-7.30), while the lifetime prevalence was 7.60 per 1,000 persons (95% CI 6.17-9.38). The annual cumulative incidence of epilepsy was 67.77 per 100,000 persons (95% CI 56.69-81.03) while the incidence rate was 61.44 per 100,000 person-years (95% CI 50.75-74.38). The prevalence of epilepsy did not differ by age group, sex, or study quality. The active annual period prevalence, lifetime prevalence, and incidence rate of epilepsy were higher in low to middle income countries. Epilepsies of unknown etiology and those with generalized seizures had the highest prevalence.
  
  
  CONCLUSIONS
  This study provides a comprehensive synthesis of the prevalence and incidence of epilepsy from published international studies and offers insight into factors that contribute to heterogeneity between estimates. Significant gaps (e.g., lack of incidence studies, stratification by age groups) were identified. Standardized reporting of future epidemiologic studies of epilepsy is needed.
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Fiest
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Khara M
authors.initials: KM
authors.lastname: Sauro
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Churl-Su
authors.initials: CS
authors.lastname: Kwon
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dykeman
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Tamara
authors.initials: T
authors.lastname: Pringsheim
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Lorenzetti
authors.affiliation: From the Department of Community Health Sciences, O'Brien Institute for Public Health (K.M.F., K.M.S., S.W., S.B.P., T.P., D.L.L., N.J.), and the Department of Clinical Neurosciences & Hotchkiss Brain Institute (K.M.S., S.W., J.D., T.P., N.J.) and Department of Psychiatry, Mathison Centre for Mental Health Research & Education (S.B.P.), Hotchkiss Brain Institute (K.M.S, S.W., S.B.P., T.P., N.J.), Department of Critical Care Medicine (K.M.F.), Cumming School of Medicine, University of Calgary, Canada; Department of Neurosurgery (C.-S.K.), King's College Hospital, London, UK; and Institute of Health Economics (D.L.L.), Edmonton, Canada. Nathalie.jette@ahs.ca.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jetté
mesh_terms: D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007391:International Cooperation; D008297:Male; D015995:Prevalence