Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures due to abnormal brain activity. Epilepsy-related mortality encompasses deaths directly due to seizures or associated conditions like Sudden Unexpected Death in Epilepsy (SUDEP). Understanding these mortality trends is crucial for identifying high-risk populations and guiding public health interventions.

We aim to analyze the demographic trends in epilepsy-related mortality in the adult population (≥25) in the United States from 1999-2020.

Mortality data from the CDC WONDER Database was analyzed using multiple-cause of death MCD-ICD 10 codes (G40.0-G40.9) in adults (≥25). Age-adjusted mortality rates (AAMRs)/100,000 and Annual percentage changes (APCs) along with 95% CI were calculated using the Joinpoint regression and stratified by age, gender, race/ethnicity, census region, state, and place of death.

There was a total of 49,883 epilepsy-related deaths in the United States from 1999-2020. Epilepsy-related morality showed a stable trend from 1999 to 2011 (APC=0.03, 95% CI: -1.05, 1.12), followed by a steep incline in AAMR from 0.8 in 2011 to 2.2 in 2020 (APC=11.73, 95% CI: 10.66, 12.81). Men showed consistently higher mortality than women from 1999 (AAMR men:1 vs women: 0.7) to 2020 (AAMR men:2.4 vs women:2). Significant racial disparities were also observed with Non-Hispanic (NH) blacks showing the highest AAMR (1.9) followed by NH American Indian or Alaska Native (1.5), NH white (1) and Hispanics (1). When stratified by census region the highest AAMR was observed in the western region (1.4) while South Dakota showed the highest state-level mortality (AAMR:1.8). Most cases of epilepsy-related mortality occurred at home (39.3%).

The study highlights a significant rise in epilepsy-related mortality in the U.S. adult population from 2011 to 2020, with notable disparities across gender, race, and geography. Further studies and targeted management strategies are required to address these disparities.