Biological complexity of epileptogenesis and the emerging role of natural molecules in neuroprotection: A review

Abstract

Epilepsy, a neurologically heterogeneous disorder, affects approximately 50 million individuals globally, with a lifetime incidence of around 3 %. For example, in the United States, active epilepsy affects 1.1 % of adults. The disease has a complex biological nature, encompassing genetic factors, molecular-cellular and epigenetic mechanisms and the "triad" of oxidative stress, neuroinflammation and neuronal degeneration. Although traditional antiepileptic drugs (AEDs) provide symptomatic control, their inherent limitations, particularly in the treatment of drug-resistant epilepsy (affecting one-third of patients), as well as the lack of disease-modifying properties highlight a significant therapeutic gap. Strategies for AED use underscore the need to expand therapeutic approaches. A potential avenue in the field of pharmacological prevention today is herbal drugs, with their pleiotropic neuroprotective activity. They represent a potential area for new approaches that modulate molecular and cellular pathways. The aim of this paper was to synthesise information on this topic while discussing the potential of the phytotherapeutic approaches described to date.