Targeted Nanomedicines and Advanced Therapies in Epilepsy Treatment

Abstract: Epilepsy is a persistent and intricate condition, standing as one of the most prevalent neurological disorders globally, impacting approximately 50 million individuals. The employment of nanomedicines has emerged as a promising strategy to administer drugs to the brain, thereby enhancing their therapeutic ratio. The complexity of epilepsy lies in its inheritance and etiology, which involve a multitude of genetic and epigenetic mechanisms. A multitude of medications are presently being examined in the realm of clinical practice, encompassing those that possess a mechanism analogous to that of renowned antiseizure medications (ASMs), such as the agonists of the GABA-A receptor, as well as those with innovative mechanisms, exemplified by the activation of melatonin receptors. This article explores innovative therapies for epilepsy management, focusing on nanoparticles, such as liposomes, polymeric nanoparticles, and dendrimers, which can be engineered to encapsulate and release antiepileptic drugs (AEDs) with exceptional precision. By functionalizing these nanoparticles with targeting ligands, they can be directed specifically to epileptic brain regions, minimizing off-target effects. Nanoscale drug carriers can modulate the release kinetics of AEDs, ensuring sustained therapeutic concentrations in the brain. This paper examines responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action. Furthermore, adjunctive therapies, like cannabidiol (CBD) and the ketogenic diet, have further broadened the spectrum of epilepsy management.