Epilepsy and the gut: Perpetrator or victim?

Area of Science:

• Neuroscience
• Gastroenterology
• Epileptology

Background:

• The gut-brain axis describes the bidirectional communication between the central nervous system (CNS) and the enteric nervous system.
• Epilepsy, a CNS disorder characterized by seizures, is influenced by gastrointestinal function, and vice versa.
• Gastrointestinal dysfunction and gut dysbiosis are increasingly recognized as factors in epileptogenesis and epilepsy management.

Purpose of the Study:

• To review the intricate relationship between the gut and epilepsy.
• To explore how gastrointestinal issues affect epilepsy risk and presentation.
• To discuss the impact of epilepsy and its treatments on the gut.

Main Methods:

• This narrative review synthesizes existing literature on the gut-brain axis in epilepsy.
• It examines the role of gut dysbiosis in seizure development and manifestation.
• It explores various gut-focused interventions for epilepsy management.

Main Results:

• Gastrointestinal dysfunction can elevate epilepsy risk and be misdiagnosed, particularly in infants.
• Epilepsy can manifest with gastrointestinal symptoms, and antiseizure medications often cause gut-related side effects.
• Interventions such as probiotics, ketogenic diets, and vagus nerve stimulation have shown efficacy in managing epilepsy.

Conclusions:

• The gut-brain axis plays a crucial role in epilepsy, affecting both its development and management.
• Targeting the gut microbiome and function offers promising therapeutic strategies for epilepsy.
• Further research into gut-based interventions is warranted for comprehensive epilepsy care.