Advancements in Epilepsy Treatments: A Comprehensive Review

Epilepsy affects approximately 50 million people worldwide, with nearly one-third experiencing drug-resistant epilepsy (DRE).Over the past decade, treatment has evolved through novel antiseizure medications (ASMs), neuromodulation devices including vagus nerve stimulation (VNS), deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS), and brain-responsive neurostimulation (RNS), together with refinements in surgical techniques such as laser interstitial thermal therapy (LITT) and selective resections.In parallel, dietary therapies, gene-and RNA-targeted strategies for developmental and epileptic encephalopathies, and digital health technologies have expanded the therapeutic landscape.This review synthesizes recent high-quality evidence and consensus guidance with a practical lens on patient selection, efficacy, safety, health-system considerations, and the outlook for precision medicine.We provide tables summarizing key modalities and highlight real-world long-term outcomes where available.The field continues to move toward individualized, mechanism-informed, and minimally invasive care.