Infantile Onset Epilepsy Incidence: Global Review

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This explainer summarizes research on infantile onset epilepsy incidence across population-based studies.

Source: JAMA neurology

Summary

What was studied

This systematic review and meta-analysis examined the incidence, prevalence, and etiological profiles of epilepsies beginning in newborns and infants, including specific epilepsy syndromes. It included 86 population-based observational studies from 30 countries across 4 World Health Organization regions.

Researchers searched four research databases through December 18, 2025. Two reviewers independently selected studies, extracted data, and assessed study quality. Results were combined using statistical methods that allow estimates to differ between studies. The researchers also examined differences by country, region, national income level, and diagnostic criteria.

What they found

The pooled cumulative incidence of infantile-onset epilepsies within the first 2 years of life was 236.0 cases per 100,000 live births (95% confidence interval [CI], 164.7–338.2; 95% prediction interval [PI], 53.0–1044.3).

Among epilepsy syndrome subgroups, developmental and epileptic encephalopathies (DEEs) had the highest incidence: 67.7 cases per 100,000 live births (95% CI, 42.1–108.9; 95% PI, 7.1–636.1).

Infantile epileptic spasms syndrome (IESS) had the highest incidence among DEEs, at 31.6 cases per 100,000 live births (95% CI, 27.5–36.2; 95% PI, 13.7–72.6). Among self-limited epilepsies, self-limited infantile epilepsy had the highest incidence, at 13.0 cases per 100,000 live births (95% CI, 9.2–18.2; 95% PI, 6.4–26.4).

Most studies came from high-income countries in the European Region.

Limits of the evidence

Estimates varied substantially between studies, with wide prediction intervals. The pooled estimates should therefore be treated as broad indicators, not precise rates that apply everywhere. Geographic coverage was limited, with a lack of data from the African and Eastern Mediterranean Regions.

Although the review aimed to estimate both incidence and prevalence and characterize etiological profiles, the abstract does not report separate neonatal estimates, prevalence results, or etiological findings. It also does not report results on survival, remission, or functional outcomes.

For families and caregivers

This review highlights the population-level burden of epilepsy beginning early in life, particularly DEEs and IESS. Because estimates varied greatly between studies and geographic coverage was limited, the pooled figures should not be treated as precise rates for every community or as predictions of an individual child's seizure course, development, or survival. The abstract does not report treatment comparisons.

What to watch next

Population-based studies in underrepresented regions, together with long-term follow-up of survival, remission, and functional outcomes, would strengthen the evidence.

Terms in this summary

Meta-analysis: A statistical method for combining results from multiple studies.
Cumulative incidence: The occurrence of new cases in a population over a defined period, such as the first 2 years of life.
Prevalence: How many people in a population have a condition at a particular time or during a defined period.
Developmental and epileptic encephalopathies (DEEs): A group of epilepsy syndromes involving epilepsy and developmental difficulties.
Infantile epileptic spasms syndrome (IESS): An epilepsy syndrome of infancy involving epileptic spasms.
Self-limited epilepsy: An epilepsy syndrome category examined in this review, including self-limited infantile epilepsy. The abstract does not report remission outcomes.
95% confidence interval (CI): A range showing statistical uncertainty around the pooled estimate.
95% prediction interval (PI): A range showing how widely the rate could vary in another similar population or study.