Shan Tao ^1,2,3,4,5 Yahui Zhu ^6,7 Haizhi Fan ^8,9 Zeye Liu ¹⁰ Jing Xie ¹¹ Shenqi Jing ^3,4,5,8,9* Mao Li ^7*

• ¹ School of Information Management, Nanjing University, Nanjing, Jiangsu Province, China
• ² Department of Outpatient, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
• ³ Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu Province, China
• ⁴ Institute of Medical Informatics and Management, Nanjing Medical University, Nanjing, Jiangsu Province, China
• ⁵ Jiangsu Province Engineering Research Center for Chronic Disease Big Data Application and Intelligent Health Service, Nanjing, China
• ⁶ Medical School of Chinese People's Liberation Army, Beijing, China
• ⁷ Department of Neurology, Chinese PLA General Hospital, Beijing, Beijing Municipality, China
• ⁸ Center for Data Management, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
• ⁹ Department of Information Management, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Liaoning Province, China
• ¹⁰ Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing Municipality, China
• ¹¹ Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China

Epilepsy is a non-communicable chronic brain disease that affects all age groups. There are approximately 50 million epilepsy patients worldwide, which is one of the most common neurological disorder. This study reports the time trends in the burden of epilepsy from 1999 to 2019.We evaluated the disease burden and its temporal trends of epilepsy using the prevalence and years lived with disability (YLDs), which was estimated based on the Global Burden of Disease (GBD) 2019 study. The age-period-cohort (APC) model was used to estimate the temporal trends of the epilepsy prevalence and YLDs rates, and to analyze the relative risks of age, periods and queues (age/period/queue effects).In the past 30 years, the global age-standardized prevalence rate and age-standardized rate has increased by 29.61% and 27.02%, respectively. Globally, the APC model estimated the net drift of prevalence and YLDs were 0.88% (95% CI: 0.83-0.93) and 0.80% (95% CI: 0.75-0.85) per year. Amongst 204 countries and territories, the YLDs in 146 and prevalence 164 showed an increasing trend. And the risk of YLDs and prevalence increases with age, with the lowest risk among 0-4 years old and the highest risk among 75-79 years old. Unfavourable increasing period and cohort risks of YLDs and prevalence were observed.Over the past 30 years, the YLDs and prevalence of epilepsy have gradually increased globally and unfavourable increasing period and cohort risks were observed. Emphasizing epilepsy prevention, strengthening epilepsy health education, optimizing elderly epilepsy diagnosis and treatment plans, and actively promoting epilepsy diagnosis and treatment plans can effectively reduce new cases of epilepsy and related disabilities.