Intestinal microbiota as a target for treatment of epilepsy

Background: Epilepsy is a common neurological disorder that could negatively affect quality of life in epileptic patients. Antiepileptic drugs are only effective in 60–70% of patients and various therapeutic approaches have been used for the other refractory patients with different efficacies. A topic of great interest which recently has lighted a way to new treatment is the role of intestinal microbiota in epilepsy. This article aimed to investigate the possible role of these micro-organisms in development and treatment of epilepsy. Methods: I searched the medical databases within 1990-2017 interval using the following keywords: epilepsy, seizure, intestinal microbiota, treatment and ketogenic diet. English clinical studies, case reports and case series were included. The articles were reviewed and related data was extracted. Findings: Recent studies have suggested an important role for intestinal microbiota in the development of autoimmune diseases and considering the relationship between epileptogenesis and autoimmune diseases, it is proposed that intestinal microbiota might play a role in development of epilepsy too. There are also some other supporting evidences in the literature. Low- and middle-income countries have higher incidence of epilepsy which might be due to exposure to certain gut bacteria. Intestinal microbiota altered by the ketogenic diet and this alteration is needed to achieve protection against seizure in both human and mouse models. Moreover, treatment of animal models by probiotics similar to that intestinal flora which are enhanced by ketogenic diet has led to seizure protection. There is also case series of temporary seizure control in children with refractory epilepsy who undergone antibiotic therapy for infectious diseases which possibly could be explained by alteration in gut bacteria. Conclusion: There is growing evidence of the role of intestinal microbiota in etiology of epilepsy and certain types of bacteria are involved. Current findings suggest that decrease in some species of intestinal bacteria and increase in some others might lead to better seizure control in epileptic patients.

کلیدواژه ها:

epilepsy ، seizure ، treatment ، intestinal microbiota