Intracranial Drug Delivery Devices: A Promising Approach for Future Epilepsy Treatment?

Epilepsy is a prevalent neurological disorder characterized by abnormal neuronal discharges, leading to spontaneous and recurrent seizure attacks. Antiseizure Drugs (ASDs) are the primary treatment, but about 30% of patients develop Drug-Resistant Epilepsy (DRE). An important reason is the inadequate drug concentration within epileptic foci. The brain is protected by the selective blockade of the blood-brain barrier, which not only diminishes the therapeutic efficacy of ASDs but also leads to adverse effects at high doses. Epilepsy surgery may be an alternative. However, the limited indications of surgery, as well as its postoperative efficacy, restrict its wider use. Targeted delivery of ASDs to epileptic foci represents a promising approach. It enables more efficient and precise drug delivery, significantly enhancing therapeutic efficacy while minimizing systemic toxicities and improving safety and quality of life. Our review comprehensively summarizes recent studies on targeted drug delivery devices for epilepsy, including invasive, semi-invasive, and noninvasive approaches, and also explores the potential application of nanoparticles as drug carriers, hoping to provide a novel direction for future epilepsy treatment.