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REVIEW article

Front. Neurol.

Sec. Epilepsy

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1644835

Precision Medicine for Epilepsy: Challenges and Perspectives for an Optimized Clinical Care Pathway

Provisionally accepted
  • 1Eisai Inc, Nutley, United States
  • 2Paracelsus Medizinische Privatuniversitat, Salzburg, Austria
  • 3Uniklinikum Salzburg - Christian-Doppler-Klinik, Salzburg, Austria
  • 4UMIT TIROL Private Universitat fur Gesundheitswissenschaften und -technologie GmbH, Hall in Tirol, Austria
  • 5Monash University, Melbourne, Australia
  • 6Alfred University, Alfred, United States
  • 7The University of Melbourne, Melbourne, Australia
  • 8Kyoto Daigaku, Kyoto, Japan

The final, formatted version of the article will be published soon.

Epilepsies are a common, but heterogeneous group of brain disorders, characterized by an enduring predisposition to recurrent epileptic seizures. Recognizing epilepsies as a disease spectrum offers compelling opportunities to implement precision medicine in routine care. In this narrative review, we assess the status and development of precision epilepsy, compare its implementation with the advanced model of precision oncology, and discuss strategies to advance the implementation of precision medicine in epilepsy care. We aim to raise awareness about the current state-of-the-art approaches in precision epilepsy, emphasizing their potential to optimize epilepsy care. Rapid technological innovations provide the foundation to improve epilepsy research and management including the establishment of multi-dimensional biomarkers to aid disease subtyping and treatment decision. We also introduce emerging digital health technologies that will transform seizure monitoring and prediction. Advances in data science and artificial intelligence will deepen our knowledge of epilepsies, and may deconstruct and systematize historical, clinical, and descriptive concepts. Following a thorough examination of the current epilepsy landscape – including obstacles against precision medicine implementation and clinical adoption - we envision that the path towards precision epilepsy care lies in studies uncovering the mechanisms underlying systems-biology and neurophysiology-based epileptogenesis using technological innovations, such as genetic testing, fluid indicators, neuroimaging, neurophysiology, and wearable devices. We review the literature based on four core pillars - biomarkers, digital technologies, systems medicine, and data science - to pinpoint the unmet need for epilepsies and thus revolutionize disease management strategies.

Keywords: Precision Medicine in Epilepsy, Systems Medicine, biomarkers, digitaltechnologies, and Data science

Received: 10 Jun 2025; Accepted: 25 Aug 2025.

Copyright: © 2025 Morita-Sherman, Trinka, Kwan, Ikeda, Cho and Hampel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Harald Hampel, Eisai Inc, Nutley, United States

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.