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Neuroimmunology of Epilepsy: Mechanisms, Treatments, and Clinical Insights
Journal article   Open access   Peer reviewed

Neuroimmunology of Epilepsy: Mechanisms, Treatments, and Clinical Insights

Alica M Goldman, Nora Wong, Annamaria Vezzani, Krista Eschbach, Khalil Husari, Divyanshu Dubey, Anteneh M Feyissa, Teneille Gofton and Ignacio Valencia
Epilepsy currents, Forthcoming
06 Jul 2026
DOI: https://doi.org/10.1177/15357597261464381
PMID: 42416145
Featured in Collection :   Drexel's Newest Publications
url
https://doi.org/10.1177/15357597261464381View
Published, Version of Record (VoR) Open

Abstract

neuromodulation NORSE cognition therapy seizures immunity Epilepsy Surgery
Immune-mediated epilepsies represent an etiologically unique category defined by immune activation within the central nervous system that initiates a pathophysiological cascade resulting in seizures, encephalopathy, and sometimes epileptogenesis with long-term epilepsy. Once considered rare and largely confined to paraneoplastic or postinfectious syndromes, immune-mediated and inflammatory mechanisms are now recognized across a broad spectrum ranging from acute autoimmune encephalitis with reversible seizures, new-onset refractory status epilepticus, or febrile illness-related refractory status epilepticus, to chronic autoimmune-associated epilepsy and drug-refractory structural epilepsies. This review integrates historical perspectives, mechanistic insights from animal and human studies, and contemporary clinical frameworks. It synthesizes advances in neuroimmunology, clinical phenotyping, diagnostics, immunomodulatory and antiseizure therapies, neuromodulation, and patient and family centered outcomes, and outlines future directions focused on biomarker-driven precision medicine, disease-modifying strategies, and interdisciplinary care models.

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