Future Perspectives for Epilepsy

At present, epilepsy treatment is empirical, targeting seizures. Stakeholders have differing priorities. People with epilepsy and clinicians want early, accurate diagnosis and seizure control. Scientists are driven to understand the underlying processes to enable early antiepileptogenic interventions. Society prioritises burden reduction while all hope for effective prevention, particularly of sudden death. Current treatment outcomes are unpredictable, with seizure control achievable for many, but often after trial and error of different medications. The future anticipates a paradigm shift from a phenotypic to a systems-based approach, which recognises epilepsy and comorbidities as components of a range of conditions. The integration of genomics and artificial intelligence to analyse clinical, EEG, and imaging data will enhance diagnostic accuracy, facilitate personalised treatment strategies, and enable individualised minimally invasive surgery and neuromodulation. Assessment and care delivery will utilise sophisticated algorithms and personalised care plans, accessible remotely. Primary prevention will emphasise improved prenatal, neonatal, and paediatric care, as well as public health measures to prevent cerebral infections, head injuries, and stroke.