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Inflammation is now viewed by some as an intrinsic part of some forms of epilepsy, being the cause of, as well as the result of, a seizure.

In epilepsy, many of the cells that support normal neural functioning become reactive or
pro-inflammatory, including microglia, and astrocytes.

The blood–brain barrier is often dysregulated in epilepsy, and as a result, much research has focused on whether this is a cause or a result of seizures, or potentially both.

Blood–brain barrier (BBB) breakdown in epilepsy drives seizure susceptibility in a positive feedback loop, and is seen by some as a biomarker of epileptogenesis.

Antiseizure medications act on neuronal signaling, targeting ion channels, synaptic vesicle proteins, and neurotransmitter receptors at inhibitory and excitatory synapses.

Monotherapy is the preferred first-line treatment for epilepsy, with alternative or add-on therapy considered if seizures persist. Treatment choices should balance benefits, tolerability, and the risk of adverse effects or drug interactions.