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Epilepsy in adults.

Roland D Thijs1, Rainer Surges2, Terence J O'Brien3

  • 1Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands; Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, UK.

Lancet (London, England)
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PubMed
Summary
This summary is machine-generated.

Epilepsy, a common brain condition affecting millions, is increasingly understood as a complex genetic disorder. Advances in genomics and diagnostics offer hope for better treatments and potential cures.

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Area of Science:

  • Neurology
  • Genetics
  • Epileptology

Background:

  • Epilepsy affects over 70 million globally, with peak incidence in infants and the elderly.
  • Genomic advancements reveal epilepsy's complex genetic basis, shifting the view from a single cause to a multifactorial condition.
  • New classifications for seizures and epilepsy types have emerged.

Purpose of the Study:

  • To provide an overview of the current understanding of epilepsy.
  • To highlight recent advances in diagnosis, treatment, and future therapeutic strategies.
  • To emphasize the evolving paradigm of epilepsy as a complex genetic disorder.

Main Methods:

  • Review of current scientific literature on epilepsy genetics, diagnosis, and treatment.
  • Analysis of progress in genomic technology, brain imaging, and neuromodulation.
  • Discussion of clinical history, ancillary investigations, and comorbidities.

Main Results:

  • Epilepsy is a complex symptom complex with strong genetic predisposition, not a single entity.
  • Antiseizure medications control seizures in many but not all patients and do not alter long-term prognosis.
  • Epilepsy surgery offers the best chance for seizure freedom in drug-resistant focal epilepsy but is underutilized.

Conclusions:

  • Improved understanding of epilepsy development, epigenetics, and pharmacogenomics fuels hope for disease-modifying or curative treatments.
  • New technologies like seizure detection devices and responsive neural stimulation offer future therapeutic avenues.
  • A comprehensive approach integrating genetics, diagnostics, and personalized treatments is crucial for managing epilepsy.