Abstract
Epilepsy as a chronic neurological disorder is characterized by recurrent, unprovoked epileptic seizures. In about half of the people who suffer from epilepsy, the root cause of the disorder is unknown. In the other cases, different factors can cause the onset of epilepsy. In recent years, the role of gut microbiota has been recognized in many neurological disorders, including epilepsy. These data are based on studies of the gut microbiota–brain axis, a relationship starting by a dysbiosis followed by an alteration of brain functions. Interestingly, epileptic patients may show signs of dysbiosis, therefore the normalization of the gut microbiota may lead to improvement of epilepsy and to greater efficacy of anticonvulsant drugs. In this descriptive review, we analyze the evidences for the role of gut microbiota in epilepsy and hypothesize a mechanism of action of these microorganisms in the pathogenesis and treatment of the disease. Human studies revealed an increased prevalence of Firmicutes in patients with refractory epilepsy. Exposure to various compounds can change microbiota composition, decreasing or exacerbating epileptic seizures. These include antibiotics, epileptic drugs, probiotics and ketogenic diet. Finally, we hypothesize that physical activity may play a role in epilepsy through the modulation of the gut microbiota.
Highlights
Epilepsy is a chronic brain disorder that affects millions of people around the world.It is characterized by the recurrent epileptic seizures, usually of short duration, which can manifest with or without the alteration of consciousness and/or with involuntary movements that affect only one part of the body [1]
For example, that in mice treated with antibiotics or germ free, the ketogenic diet has no effect on seizures but the administration of probiotics restores the effects of the diet by regulating the glutamate-GABA axis [80]
We summarized the experimental evidence for the role of the gut microbiota in epilepsy
Summary
Epilepsy is a chronic brain disorder that affects millions of people around the world. Epilepsy must be treated with drug or surgical therapy [4] Both therapies are not free from problems, such as the lack of response or the presence of side effects, even of serious entity in the case of antiepileptic drugs [5]. For these reasons, the search for the causes of epilepsy and its treatment still represents a major challenge for the scientific community. There is much discussion on the role of intestinal microbes in the pathogenesis of many diseases of the central nervous system (CNS) [6], including epilepsy [7,8,9]
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