Approximately 3.4 million people in the United States have epilepsy, including about 3 million adults and 470,000 children. That makes it one of the most common neurological conditions in the country, roughly as prevalent as rheumatoid arthritis. About 1.1% of US adults have active epilepsy, meaning they are currently being treated or have had a seizure in the past year.
Adults vs. Children
Epilepsy affects people across every age group, but the distribution is not even. Adults account for the vast majority of cases, with roughly 2.9 million US adults living with active epilepsy based on 2021 and 2022 survey data. Children make up a smaller but significant share. New diagnoses tend to cluster at both ends of the age spectrum: epilepsy is most commonly diagnosed in young children and in adults over 65. Among older adults specifically, the incidence rate runs close to 397 new cases per 100,000 people per year, driven largely by strokes, dementia, and other age-related brain changes.
Differences by Race and Ethnicity
Epilepsy prevalence is not uniform across racial and ethnic groups. CDC data from combined national surveys found that non-Hispanic white and non-Hispanic Black adults had similar overall rates: 1.9% and 1.8%, respectively. Active epilepsy rates were also comparable between those groups (1.1% for white adults, 1.2% for Black adults). Hispanic adults, by contrast, had notably lower reported rates at 1.0% overall and 0.6% for active epilepsy. Researchers have noted that these differences could reflect true variation, differences in diagnosis rates, or survey participation patterns rather than biology alone.
How Cases Spread Across States
State-by-state numbers largely mirror each state’s population size. California, Texas, Florida, and New York have the highest raw numbers of epilepsy cases simply because they have the most residents. Eleven states each had 92,700 or more people with active epilepsy, while nine states and the District of Columbia each had fewer than 14,000. CDC modeling has found no substantial differences in epilepsy prevalence rates between states after adjusting for population, meaning you’re roughly equally likely to develop epilepsy whether you live in Montana or Massachusetts.
One exception involves older adults. A Case Western Reserve University study analyzing 4.8 million Medicare beneficiaries identified geographic clusters with higher epilepsy rates among people 65 and older, concentrated in parts of the South and Appalachia. Researchers described this pattern as an “epilepsy belt,” though the reasons behind it likely involve regional differences in stroke rates, poverty, and access to neurological care rather than anything unique to those locations.
How Many People Have Uncontrolled Seizures
Having epilepsy doesn’t necessarily mean having frequent seizures, but for a large portion of people, seizure control remains elusive. Among the estimated 2.9 million US adults with active epilepsy in 2021 and 2022, about 49% were taking medication and had no seizures in the past year. That leaves roughly half the population still experiencing seizures.
About 36% (around 1.1 million people) were taking anti-seizure medication but still had one or more seizures in the past 12 months. Another 15% (roughly 400,000 people) were not taking medication at all and had experienced seizures. Combined, that means approximately 1.5 million US adults with active epilepsy had uncontrolled seizures in a given year. The one-third figure among those on medication lines up closely with clinical estimates that about a third of epilepsy cases are resistant to medication.
Income plays a role in seizure control. People with lower annual family incomes were more likely to report uncontrolled seizures, pointing to barriers like medication costs, limited access to specialists, and fewer options for advanced treatments like surgery or newer therapies.
Deaths From Epilepsy
Epilepsy carries real mortality risk. Over 3,000 Americans die each year from sudden unexpected death in epilepsy (SUDEP), a poorly understood phenomenon in which a person with epilepsy dies during or shortly after a seizure with no other identifiable cause. SUDEP is most common in people with frequent, uncontrolled generalized seizures, particularly those that happen during sleep. The risk is significantly lower for people whose seizures are well managed.
The Financial Burden
Epilepsy is expensive to manage. Direct healthcare spending for the 3.4 million Americans with epilepsy and seizure disorders totals roughly $24.5 billion per year, based on CDC analysis of data from 2010 through 2018. On an individual level, a person with epilepsy spends about $6,850 more per year on healthcare than someone without the condition, even after adjusting for other health issues and demographic factors. Those costs come from medication, emergency visits, specialist appointments, imaging, and in some cases hospitalization or surgery. The total economic impact, including lost productivity and indirect costs, pushes far beyond that $24.5 billion figure.