A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

Abstract

Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.

Navigating Social Waters: Understanding Theory-of-Mind Challenges in Patients with Mesial Temporal Lobe Epilepsy

“…Despite significant developments in the available therapeutic options [ 53 ], there is still a need for new therapies for epilepsy patients, including neuropsychological therapy. Patients with MTLE face challenges in social competence, which influences various aspects of their lives.…”

Functional Characteristics of the Nav1.1 p.Arg1596Cys Mutation Associated with Varying Severity of Epilepsy Phenotypes

“…One of them is pharmacological modulation of the K+Cl-cotransporter [20]. Other methods include responsive neurostimulation, vagus nerve stimulation and deep brain stimulation [16]. Dietary interventions can also be considered [21].…”

“…There were no significant changes during the depolarization phase of the threshold electrotonus between the data recorded for patients and for the control group (Figure 4C; for excitability changes (Td) in all time intervals, see Table 1). However, in the hyperpolarizing part of the threshold electrotonus, there was a significantly greater decrease in membrane excitability (so-called fanning out, see [16]) found in subjects with a mutation compared to the control group and seen at both −20% and −40%, progressing during the time course of the hyperpolarizing pulse. For the time interval of 90-100 ms of −40%, the hyperpolarizing pulse excitability change was −130.37% ± 7.3 n = 5 for mutation carriers and −83.9% ± 11.65 for the control group; n = 10, p = 0.041, t-test (see Table 1 for the remaining excitability parameters during hyperpolarization).…”

Cannabidiol Exerts Anticonvulsant Effects Alone and in Combination with Δ9-THC through the 5-HT1A Receptor in the Neocortex of Mice

“…Currently, Epidiolex is a medication that was approved by the United States Food and Drug Administration (FDA) for patients with Dravet syndrome and Lennox–Gastaut syndrome. Epidiolex is a pure CBD product, and although it has been shown to be effective, further studies are required to expand our knowledge regarding its use for non-pediatric epilepsy and other epilepsy types [ 15 , 16 ]. Nevertheless, CBD does display promising anticonvulsant effects, high tolerability, and low toxicity, further supporting its safe use as a therapeutic [ 17 , 18 ].…”