Is Epilepsy Curable? Research and Medical Advancements

There’s currently no cure for epilepsy. While medications can limit or eliminate seizures in many people, sometimes epilepsy doesn’t respond to medications. Understanding the mechanisms behind epilepsy can help researchers develop more effective medications and surgery.

Epilepsy is a brain disorder that causes recurring seizures. During a seizure, nerve cells in the brain signal quickly at the same time. This can lead to temporary changes in movement, sensations, or behavior.

While epilepsy can be managed with treatment, there’s currently no cure for it. Doctors and scientists continue to research potential cures. Keep reading to learn about the progress and challenges in curing epilepsy.

Is epilepsy curable?

Epilepsy is one of the most common neurological disorders globally, affecting an estimated 50 million people. Within the United States, about 3 million adults are living with epilepsy.

There’s currently no cure for epilepsy. However, effective treatments are available. Researchers estimate that about 70% of people with epilepsy can be seizure-free when their epilepsy is accurately diagnosed and treated.

Many people who are seizure-free may not ever have another seizure. Others may only have occasional seizures. Factors that increase the likelihood of being seizure-free include having:

• epilepsy that has an unknown cause
• a response to the first one or two seizure medications that you’re prescribed
• no family history of epilepsy
• no personal history of brain conditions like brain injury
• typical neurological exam and electroencephalogram (EEG) results
• no concerning findings on imaging tests like CT or MRI

Challenges to finding an epilepsy cure

One challenge to curing epilepsy is that its exact cause is unknown. Further complications in research include the following:

• The brain is incredibly complex. In fact, we’re still continuing to learn more about how the brain typically functions.
• There are several types of epilepsy, and each one potentially has unique causes.
• There are hundreds of ways to cause seizures, making locking down specific mechanisms and designing research studies difficult.

Other open research questions that could be relevant to improved epilepsy treatments or a cure that doctors and scientists are investigating include:

• What are the mechanisms by which seizures start and stop in people with epilepsy?
• Why do some seizures occur in response to specific factors?
• What are the mechanisms through which current seizure medications work to prevent seizures?
• How exactly do seizures impact brain function or structure?

Despite these challenges, doctors and scientists continue to strive to increase our knowledge of epilepsy. Knowing the mechanisms by which epilepsy develops can help to uncover ways to better treat, prevent, or even cure it.

What are the most recent advancements in an epilepsy cure?

Many clinical trials are going on to improve epilepsy treatments. Currently, there are over 300 interventional trials for epilepsy that are either currently active or looking for participants.

Let’s take a look at some advancements in epilepsy research now.

Epilepsy mechanisms

Two potential mechanisms are particularly promising targets for new epilepsy medications. These are the mTOR pathway and the cytokine IL-1ß.

The mTOR pathway is involved in several types of epilepsy. Research has found that this pathway directly influences the excitability of nerve cells and the progression of epilepsy. Drugs affecting the mTOR pathway are already used to treat some cancers.

Cytokines are involved in inflammation. It’s believed that inflammation could affect the connections between nerve cells and may also make them more excitable. The cytokine IL-1ß appears to be particularly important in these processes.

Drugs that target levels of specific cytokines are already used to treat a variety of inflammatory conditions.

New epilepsy treatments

There are also different treatments being developed for epilepsy. These include new medications and surgical procedures.

A 2023 clinical trial found that, when added to current treatments, a new drug called XEN1101 was associated with reduced seizures in people with focal seizures.

Trial participants had already tried and stopped a median (average) of six seizure medications prior to this trial. Higher doses of XEN1101 led to greater seizure reduction. The new drug had side effects similar to other seizure medications.

Meanwhile, a 2024 study reported on a new potential surgical target for medial temporal lobe epilepsy. This area is called the fasciola cinereum and appears to be involved in starting seizures in this type of epilepsy.

Examples of other newer types of treatment being investigated for epilepsy include:

• gene therapies
• stem cell therapies
• cannabidiol (CBD)

How is epilepsy treated?

While there’s currently no cure for epilepsy, a variety of treatments can help to manage it.

Epilepsy medications

There are now over 40 medications, called anti-epileptic drugs (AEDs), that are available to manage seizures. AEDs are effective in roughly two-thirds of people with epilepsy, although some people may need to try different dosages or more than one AED before an effective one is found.

Epilepsy devices

Implanted devices, such as those used in vagus nerve stimulation and deep brain stimulation, may also be used to reduce seizures in people who don’t respond to AEDs. These devices work by sending electrical impulses to areas of the brain impacted by seizures, helping to prevent or stop seizures from happening.

Epilepsy surgery

Surgery is considered when two or more AEDs have been ineffective or when a doctor knows the area of the brain that’s causing seizures. Several different types of surgery may be used for epilepsy.

Dietary therapies

A ketogenic (keto) diet is high in fat and low in carbohydrates. There’s evidence that following a keto diet can help reduce seizures in people with epilepsy, especially those who haven’t responded to treatment with AEDs.

What is the outlook for living with epilepsy?

The outlook for epilepsy is generally positive. Many people with epilepsy do respond to treatment with AEDs. They may have significantly fewer seizures or may stop having seizures altogether.

However, about one-third of people living with epilepsy have seizures that are resistant to medications. In these situations, treatment may involve the use of surgery, epilepsy devices, or dietary therapy.

Epilepsy can also have a significant effect on quality of life. It’s also associated with a higher chance of mood disorders like depression.

There’s also some evidence that people with epilepsy have a lower life expectancy compared to the general population. A 2023 study found that life expectancy was reduced by about 12 years in males and 11 years in females.

Frequently asked questions about epilepsy

Here are answers to some frequently asked questions about epilepsy.

Can epilepsy be cured by surgery?

Surgery may be able to significantly lower or halt seizures. However, it may not reduce or stop seizures in all people and may also lead to changes in personality, thinking, and movement.

Can epilepsy go away?

Yes. Many people with epilepsy can be seizure-free when their condition is accurately diagnosed and appropriately treated.

Can I live a normal life with epilepsy?

Yes. While epilepsy affects each person differently, people living with epilepsy can go on to lead full, active lives.

Does epilepsy get worse as you age?

It’s possible for epilepsy to get worse as you age. Management of epilepsy can become complicated in older adults due to other underlying health conditions and medication side effects or interactions.

However, it may also improve as you get older. Older research has found that about 74% of children with new-onset seizures are seizure-free within 2 years.

Takeaway

There’s no cure for epilepsy, but effective treatments are available. A lack of understanding of the exact mechanisms behind the development of epilepsy and its associated seizures is one important hurdle in finding a cure.

Researchers continue to look into treatments that can treat epilepsy more effectively, or that may cure it. This is particularly important for the one-third of people whose epilepsy doesn’t respond to our current AEDs.

With appropriate diagnosis and treatment, many people with epilepsy can become seizure-free by using AEDs. Those with medication-resistant epilepsy may be treated using surgery, epilepsy devices, or dietary therapies.