Title : The role of gut-brain axis in epilepsy
Abstract:
Epilepsy is a common neurological disorder with negative effects on quality of life. In about one third of patients, epilepsy is resistant to common antiseizure medications. The low possibility of response to medical therapy in this group of patients demonstrates the urgent need to find and use other alternative therapeutic methods. Few recent studies have suggested the role of gut microbiota in epilepsy. In this review, I aimed to investigate the possible role of these micro-organisms in the development and treatment of epilepsy.
Changes in gut microbiota may influence seizure pathogenesis by different mechanisms. Recent studies have shown that alteration in intestinal microbiota is necessary to achieve protection against seizure in both human and animal models. Moreover, treatment of animal models by probiotics similar to the intestinal flora which are enhanced by ketogenic diet, has led to seizure protection. There are reports of temporary seizure control in children and adults with refractory epilepsy who received antibiotic therapy. Partial improvement in patients with epilepsy who received probiotics as supplementary treatment is reported in a recent study as well. In addition, fecal microbiota transplantation has led to cure of epilepsy in a patient with epilepsy and Crohn’s disease. The results of these studies suggest the possible role of gut bacteria in pathogenesis and treatment of epilepsy. However, well-designed placebo-controlled clinical trials with larger sample sizes and fecal microbiota analysis are necessary to clarify this issue and resolve the contradictions.
