MICROBIOTA

microbiotakapak

THE NEXUS BETWEEN GUT MICROBIOTA AND EPILEPSY

Fatma Zehra Altunç1
Cenk Altunç2
Arif Tolga Sönmez3

1AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye
2Ankara Bilkent City Hospital, Department of Intensive Care, Ankara, Türkiye
3AnkaraEtlik City Hospital, Department of Neurology, Ankara, Türkiye

Altunç FZ, Altunç C, Sönmez AT. The Nexus Between Gut Microbiota and Epilepsy. Melek İM, Aydoğan S, eds. Microbiota. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.171-177.

ABSTRACT

Epilepsy is a chronic neurological disease characterised by recurrent seizures caused by abnormal, excessive and/or synchronous neurological activity that affects more than 70 million people worldwide. Recently, there has been an increasing interest in the relationship between gut microbiota and the central nervous system (CNS). Studies on the relationship between CNS diseases and microbiota have been strongly associated with Parkinson’s Disease, Multiple Sclerosis, Alzheimer’s Disease, and Amyotrophic Lateral Sclerosis, with the view that microbiota-derived metabolites contribute to neurodegeneration. This relationship has been emphasised as significant in both prognosis and treatment. Although there is a limited number of studies on epilepsy and microbiota, the impact of the ketogenic diet on flora and seizures has garnered increasing interest today. The first case report on the relationship between epilepsy and gut microbiota was published by He Z. et al. in 2017, highlighting the possible effect of faecal transplant on seizures.Various cohort studies, which gained momentum following the case report, have revealed differences in gut microbiota among drug-sensitive epilepsy, drug-resistant epilepsy, and healthy volunteer groups. The results of the cohort studies indicate a decrease in Bacteroides and Actinobacteria in the gut microbiota of epilepsy patients, while they show an increase in Proteobacteria. As it has become more popular in recent years, the effect of a ketogenic diet on microbiota and seizure-inducing mechanisms in pediatric patients with resistant epilepsy has also been researched. The ketogenic diet is considered to have an anti-seizure effect through neurotransmitter changes, biogenic monoamines, and neuroprotective mechanisms. Ketone bodies affect not only

g-aminobutyric acid (GABA) and Glutamate neurotransmitter levels and receptors but also dopamine, serotonin, adenosine, and epinephrine levels, thereby providing anti-seizure effects through monoamines. Additionally, it enhances mitochondrial membrane stabilisation and reduces oxidative stress.

Keywords: Brain-gut axis; Epilepsy; Diet, Ketogenic

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