Epilepsy: epidemiology, risk factors, classification, pathophysiology, clinical features, diagnosis and management
4 affiliations
- 1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- 2Sichuan Provincial Engineering Research Center of Brain-Machine Interactive Neuromodulation, Chengdu, China
- 3Laboratory of Neuro-diseases and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- 4Sichuan Provincial Model Worker and Craftsman Innovation Studio, Chengdu, China
Abstract
Epilepsy is one of the most prevalent and disabling neurological disorders, affecting >50 million people worldwide. Beyond recurrent seizures, it is strongly associated with cognitive impairment, psychiatric comorbidities, reduced social participation, and a markedly increased risk of premature death. Although considerable advances in neuroimaging, pharmacology, and surgical techniques have expanded therapeutic possibilities, nearly one-third of patients remain refractory to current treatments, a challenge that highlights the pressing need for deeper mechanistic insights and innovative therapeutic strategies. This review provides an integrated overview of recent progress in epilepsy research and treatment. At the molecular level, we examine how ion channel dysfunction, receptor abnormalities, and disrupted signaling pathways drive hyperexcitability. We highlight insights from genetics and acquired etiologies that illuminate disease heterogeneity. We address prevailing hypotheses of drug resistance and potential biomarkers. We also emphasize the growing recognition of epilepsy’s close association with diverse comorbidities, where shared molecular pathways not only deepen our understanding of disease mechanisms but also highlight new therapeutic targets. Finally, we evaluate emerging therapeutic directions, including precision pharmacology, neuromodulation, gene and cell therapies, and metabolic approaches such as the ketogenic diet. By bridging epidemiological perspectives with mechanistic discoveries and innovative therapies, this review underscores how advances in epilepsy research are reshaping the path toward precision medicine and improved patient outcomes.
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BibTeX
@article{sha2026epilepsy,
title = {{Epilepsy: epidemiology, risk factors, classification, pathophysiology, clinical features, diagnosis and management}},
author = {Leihao Sha and Yutong Fu and Sijia Basang and Ling Jin and Sikai Huang and Ting Chen and Jingxuan Zhang and Mengqiao He and Jiaxian Zhang and Lei Chen},
journal = {Signal Transduction and Targeted Therapy},
year = {2026},
month = nov,
doi = {10.1038/s41392-026-03104-6},
url = {https://doi.org/10.1038/s41392-026-03104-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Epilepsy: epidemiology, risk factors, classification, pathophysiology, clinical features, diagnosis and management
AU - Leihao Sha
AU - Yutong Fu
AU - Sijia Basang
AU - Ling Jin
AU - Sikai Huang
AU - Ting Chen
AU - Jingxuan Zhang
AU - Mengqiao He
AU - Jiaxian Zhang
AU - Lei Chen
PY - 2026
DA - 2026/11/04
JO - Signal Transduction and Targeted Therapy
DO - 10.1038/s41392-026-03104-6
UR - https://doi.org/10.1038/s41392-026-03104-6
AB - Epilepsy is one of the most prevalent and disabling neurological disorders, affecting >50 million people worldwide. Beyond recurrent seizures, it is strongly associated with cognitive impairment, psychiatric comorbidities, reduced social participation, and a markedly increased risk of premature death. Although considerable advances in neuroimaging, pharmacology, and surgical techniques have expanded therapeutic possibilities, nearly one-third of patients remain refractory to current treatments, a challenge that highlights the pressing need for deeper mechanistic insights and innovative therapeutic strategies. This review provides an integrated overview of recent progress in epilepsy research and treatment. At the molecular level, we examine how ion channel dysfunction, receptor abnormalities, and disrupted signaling pathways drive hyperexcitability. We highlight insights from genetics and acquired etiologies that illuminate disease heterogeneity. We address prevailing hypotheses of drug resistance and potential biomarkers. We also emphasize the growing recognition of epilepsy’s close association with diverse comorbidities, where shared molecular pathways not only deepen our understanding of disease mechanisms but also highlight new therapeutic targets. Finally, we evaluate emerging therapeutic directions, including precision pharmacology, neuromodulation, gene and cell therapies, and metabolic approaches such as the ketogenic diet. By bridging epidemiological perspectives with mechanistic discoveries and innovative therapies, this review underscores how advances in epilepsy research are reshaping the path toward precision medicine and improved patient outcomes.
SN - 2095-9907
SN - 2059-3635
ER -