WONOEP XVII appraisal: The immunopathogenesis of epilepsy

There is a wealth of data indicating that the immune system plays an important role in seizure disorders. This includes autoimmune encephalitis, in which an immune response directed against neuronal antigens results in brain inflammation and subsequent seizure activity, as well as autoimmune-associated epilepsy and neuroinflammatory changes detected in the tissues of patients with epilepsy, in which context it is often difficult to distinguish whether the inflammation is causal or a consequence of the seizures. Here, we summarize the discussion on this topic held during the XVII Workshop on Neurobiology of Epilepsy (WONOEP XVII), organized in 2023 by the Neurobiology Commission of the International League Against Epilepsy on the topic of the extracellular space in epilepsy. This critical appraisal explores the progress, emerging concepts, and discussion on the immunopathogenesis of epilepsy, with a particular focus on the interplay between the immune system and the central nervous system, highlighting the role of autoimmunity, neuroinflammation, and neuroimmunological processes in the etiology of various epileptic disorders and the prospects for new therapies.