School of Medicine Publications

Document Type

Article

Publication Date

2026

Abstract

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, affecting approximately 50 million individuals globally. While conventional antiseizure medications (ASMs) control seizures in 70-80% of patients, about 30% experience drug resistance or intolerable side effects, necessitating alternative approaches.

Objective: To critically compare the efficacy, safety, and accessibility of conventional and emerging therapies for epilepsy, particularly in the context of treatment-resistant cases and global disparities in care.

Methods: This narrative review synthesized evidence from 120 peer-reviewed articles published between 2015 and 2025. Literature was retrieved from PubMed, Embase, Cochrane Library, and Scopus using predefined search terms related to epilepsy treatments. Comparative analysis included therapeutic mechanisms, clinical outcomes, and implementation barriers.

Results: Conventional treatments such as phenytoin, valproate, levetiracetam, surgical resection, ketogenic diet, and vagus nerve stimulation (VNS) offer 70-80% seizure control. However, emerging therapies are gaining prominence. Cannabidiol (CBD) demonstrates a 30-50% seizure reduction, while responsive neurostimulation (RNS) achieves 50-70% efficacy, especially in drug-resistant epilepsy. Despite these advancements, a 75% treatment gap persists in low-income countries due to limited resources, access, and trained personnel.

Conclusion: Emerging therapies hold promise for managing refractory epilepsy, yet global disparities limit their reach. Precision medicine strategies must be coupled with efforts to improve access in underserved regions. This review provides practical insights for personalized care and advocates for increased investment in equitable treatment infrastructure.

Comments

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Annals of Medicine & Surgery

DOI

10.1097/MS9.0000000000004295

Academic Level

faculty

Mentor/PI Department

Medical Education

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