Biomarkers in Epilepsy: Emerging Tools for Diagnosis, Prognosis and Therapeutic Strategies

Epilepsy is one of the most prevalent neurological disorders, affecting nearly 50 million individuals worldwide and contributing significantly to the global burden of disease. Despite advances in antiepileptic drug development, approximately 30% of patients remain drug-resistant, underscoring the urgent need for precision-based diagnostic and therapeutic strategies. Biomarkers have emerged as promising tools to improve epilepsy diagnosis, prognosis, and treatment response. Genetic biomarkers, including ion channel mutations and mTOR pathway genes, aid in identifying epilepsy subtypes and guiding personalized therapy. Molecular biomarkers such as cytokines, oxidative stress indicators, and neurotransmitter imbalances provide insights into disease mechanisms and epileptogenesis. Imaging biomarkers, particularly MRI and advanced neuroimaging modalities, enhance lesion detection and disease monitoring. Novel candidates such as microRNAs, proteins, and amino acids further expand the biomarker landscape, reflecting underlying pathophysiological processes. Collectively, these advances highlight the importance of integrating biomarker research with clinical practice to enable early detection, individualized management, and improved therapeutic outcomes in epilepsy.