Epilepsy is a common chronic
neurological disorder in modern society. One of the major unmet challenges is that current antiseizure medications are basically not disease-modifying. Among the multifaceted etiologies of
epilepsy, the role of the immune system has attracted considerable attention in recent years. It is known that both innate and adaptive immunity can be activated in response to insults to the central nervous system, leading to
seizures. Moreover, the interaction between
ion channels, which have a well-established role in epileptogenesis and
epilepsy, and the immune system is complex and is being actively investigated. Some examples, including the interaction between
ion channels and mTOR pathways, will be discussed in this paper. Furthermore, there has been substantial progress in our understanding of the pathophysiology of
epilepsy associated with
autoimmune encephalitis, and numerous neural-specific
autoantibodies have been found and documented. Early recognition of immune-mediated
epilepsy is important, especially in cases of pharmacoresistant
epilepsy and in the presence of signs of
autoimmune encephalitis, as early intervention with
immunotherapy shows promise.