{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:17:57Z","timestamp":1783585077883,"version":"3.55.0"},"reference-count":82,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Epilepsy Curr"],"abstract":"<jats:p>Immune-mediated epilepsies represent an etiologically unique category defined by immune activation within the central nervous system that initiates a pathophysiological cascade resulting in seizures, encephalopathy, and sometimes epileptogenesis with long-term epilepsy. Once considered rare and largely confined to paraneoplastic or postinfectious syndromes, immune-mediated and inflammatory mechanisms are now recognized across a broad spectrum ranging from acute autoimmune encephalitis with reversible seizures, new-onset refractory status epilepticus, or febrile illness-related refractory status epilepticus, to chronic autoimmune-associated epilepsy and drug-refractory structural epilepsies. This review integrates historical perspectives, mechanistic insights from animal and human studies, and contemporary clinical frameworks. It synthesizes advances in neuroimmunology, clinical phenotyping, diagnostics, immunomodulatory and antiseizure therapies, neuromodulation, and patient and family centered outcomes, and outlines future directions focused on biomarker-driven precision medicine, disease-modifying strategies, and interdisciplinary care models.<\/jats:p>","DOI":"10.1177\/15357597261464381","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:37:21Z","timestamp":1783323441000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimmunology of Epilepsy: Mechanisms, Treatments, and Clinical Insights"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-5746","authenticated-orcid":false,"given":"Alica M.","family":"Goldman","sequence":"first","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Wong","sequence":"additional","affiliation":[{"name":"NORSE Institute, Summit, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-6175","authenticated-orcid":false,"given":"Annamaria","family":"Vezzani","sequence":"additional","affiliation":[{"name":"Mario Negri Institute for Pharmacological Research IRCCS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Eschbach","sequence":"additional","affiliation":[{"name":"Children's Hospital Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Husari","sequence":"additional","affiliation":[{"name":"John Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divyanshu","family":"Dubey","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9318-3947","authenticated-orcid":false,"given":"Anteneh M.","family":"Feyissa","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teneille","family":"Gofton","sequence":"additional","affiliation":[{"name":"Western University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-4933","authenticated-orcid":false,"given":"Ignacio","family":"Valencia","sequence":"additional","affiliation":[{"name":"Cooper University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.8.6.435"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.8.2866"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh203"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21050"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70310-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.178"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0217-x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-012-0992-7"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2005.07.063"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2007.08.012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14038"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/erm.2020.5"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-021-02285-1"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2022.105964"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41583-024-00805-1"},{"key":"e_1_3_2_18_2","first-page":"611","volume-title":"Jasper\u2019s basic mechanisms of the epilepsies","author":"Dingledine R","year":"2024","unstructured":"Dingledine R, Varvel NH, Ravizza T, Vezzani A. Neuroinflammation in epilepsy: cellular and molecular mechanisms. In: Noebels JL, Avoli M, Rogawski MA, Vezzani A, Delgado-Escueta AV, eds. Jasper\u2019s basic mechanisms of the epilepsies. 5th ed. Oxford Academic; 2024: 611\u2013632.","edition":"5"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-022-01095-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271995"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2010.02547.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2013.04.023"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-020-0369-8"},{"key":"e_1_3_2_24_2","first-page":"789","volume-title":"Jasper\u2019s basic mechanisms of the epilepsies","author":"Koepp MJ","year":"2024","unstructured":"Koepp MJ, Balestrini S, Dedeurwaerdere S, Theodore WH. Genetic and imaging biomarkers of epileptogenesis. In: Noebels JL, Avoli M, Rogawski MA, Vezzani A, Delgado-Escueta AV, eds. Jasper\u2019s basic mechanisms of the epilepsies. 5th ed. Oxford Academic; 2024: 789\u2013810.","edition":"5"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14016"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1323848"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12944"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109095"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17933"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI125178"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16571"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/epd2.20231"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17699"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26013"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-325011"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.5429"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18238"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.78204"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012465"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24979"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200422"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1660860"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.01.021"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09807-2"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16888"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03609.x"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13797"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25655"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2021-327302"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-019-00750-3"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18654"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000552"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000383"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200395"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-016-0442-6"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-020-00921-7"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213487"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1215\/S1152851703000395"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70006"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25421"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-13495-1"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-025-01089-4"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac404"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2016.12.010"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-325275"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-025-06652-y"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1177\/20406223211066738"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18086"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2017.02.011"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12395"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2024.03.032"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2022.106974"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2025.100755"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2018.0993"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24821"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2025.114941"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-93265-x"},{"key":"e_1_3_2_79_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2024.110236"},{"key":"e_1_3_2_80_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17950"},{"key":"e_1_3_2_81_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18267"},{"key":"e_1_3_2_82_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001940"},{"key":"e_1_3_2_83_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.12.004"}],"container-title":["Epilepsy Currents"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15357597261464381","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15357597261464381","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15357597261464381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:48:38Z","timestamp":1783583318000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15357597261464381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":82,"alternative-id":["10.1177\/15357597261464381"],"URL":"https:\/\/doi.org\/10.1177\/15357597261464381","relation":{},"ISSN":["1535-7597","1535-7511"],"issn-type":[{"value":"1535-7597","type":"print"},{"value":"1535-7511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"article-number":"15357597261464381"}}