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Anti\u2010seizure medications (ASMs) are the first choice for clinicians to control unprovoked epileptic seizures. Although more than 30 ASMs are available in the market, patients with epilepsy (PWEs) still show poor responses to adequate drug treatment. Meanwhile, long\u2010term medications not only bring heavy financial burdens but also lead to undesirable side effects. Music, a ubiquitous art form throughout human history, has been confirmed as therapeutically effective in various neurological conditions, including epilepsy. This alternative therapy offers convenience and a relatively safe approach to alleviating epileptic symptoms. Paradoxically, besides anti\u2010convulsant effect, some particular music would cause seizures inversely, indicating the pro\u2010convulsant effect of it. Considering that investigating the impact of music on epilepsy emerges as a compelling subject. In this review, we tried to present the following sections of content on this topic. Initially, we overviewed the impact of music on the brain and the significant progress of music therapy in central neurological disorders. Afterward, we classified the anti\u2010convulsant and pro\u2010convulsant effects of music in epilepsy, relying on both clinical and laboratory evidences. Finally, possible mechanisms and neural basis of the music effect were concluded, and the translational potentials and some future outlooks about the music effect in epilepsy were proposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Epilepsy is an extremely severe neurological disorder. Although anti\u2010seizure medications are preferred choice to control seizures, the efficacy is not satisfied due to the tolerance. Anecdotal music effect had been deemed functional diversity but not clarified on epilepsy, pro\u2010convulsive, or anti\u2010convulsive. Here, we reviewed this interesting but puzzling topic, as well as illustrating the potential mechanisms and its translational potential.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.13064","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T09:38:46Z","timestamp":1728985126000},"page":"2112-2127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The bidirectional role of music effect in epilepsy: Friend or foe?"],"prefix":"10.1002","volume":"9","author":[{"given":"Shajing","family":"Gao","sequence":"first","affiliation":[{"name":"Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Gong","sequence":"additional","affiliation":[{"name":"Key Laboratory of Neuropharmacology and 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