Machine learning prediction for epilepsy treatment selection and prognosis: achievements and challenges

Accurate prediction of treatment response and selection of optimal treatments remain challenging in epilepsy management. With no reliable surrogate biomarkers for treatment response, the current process of selecting an antiseizure medication remains largely a trial-and-error approach. Other non-pharmacological treatment options, such as epilepsy surgery, are viable alternatives for patients with drug-resistant epilepsy. Statistical and machine learning techniques have been used to predict seizure outcomes associated with antiseizure medications and epilepsy surgery. Recent breakthroughs in deep learning have unveiled new pathways and opportunities, potentially revolutionising personalised treatment selection in health care. In this Review, we explore a broad range of studies that have used various statistical and machine learning methodologies, with particular emphasis on state-of-the-art deep learning techniques to predict the outcomes of both pharmaceutical and surgical treatments for epilepsy. We also review potential future research trajectories and address the inherent challenges of incorporating machine learning into the clinical management of epilepsy.