Vascular epilepsy in adulthood: current status and outlook for research and management

Abstract Background Vascular epilepsies can manifest at various stages of adulthood and are often accompanied by age-related comorbidities. Aging processes, particularly vascular and neurodegenerative changes, contribute significantly to the risk of late-onset epilepsy (LOE). Methods This narrative review explores the emerging role of the glymphatic system in the pathogenesis of vascular-related adult-onset epilepsy in the context of aging. Both established antiseizure medications (ASMs) and novel preventive strategies currently under investigation are evaluated. Results and conclusion The review emphasizes the importance of an interdisciplinary management approach and discusses practical considerations for optimizing care in this patient population.