Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures, affecting over 50 million people's health worldwide, with nearly 30% of patients unable to achieve seizure control through medication. Notably, individuals with inflammatory bowel disease are at a higher risk of developing epilepsy. The gut-brain axis refers to the bidirectional communication between the gut and the brain, regulating intestinal homeostasis and central nervous system function through neural networks, neuroendocrine, immune, and inflammatory pathways. Recent studies suggested that gut dysfunction and dysbiosis might play a role in the pathogenesis and susceptibility of epilepsy. Additionally, interventions such as fecal microbiota transplantation, probiotic therapy, and ketogenic diets, which aim to restore gut microbiota balance, have shown promising effects in the treatment of refractory epilepsy, further supporting a potential link between the gut microbiota and epilepsy. This paper describes the microbial-gut-brain axis, synthesizing what is known from previous studies about the role of the gut microbiota in the pathogenesis and treatment of epilepsy, to inform the exploration of new gut microbiota-based therapeutic options for epilepsy.

癫痫是一种以反复发作、无端发作为特征的慢性神经系统疾病，影响着全世界5 000多万人的健康，近30%的癫痫患者无法用药物控制。值得注意的是，有炎症性肠病患者更容易患癫痫。肠脑轴是指肠道与大脑之间的双向交流，通过神经网络和神经内分泌、免疫、炎症等途径调节肠道内稳态和中枢神经系统。最近的研究表明，肠道功能障碍以及生态失调可能与癫痫的发病机制和易感性有关。此外，粪便微生物群移植、益生菌干预和生酮饮食等方式重建肠道微生物群在顽固性癫痫治疗中展现出良好的效果，进一步支持了肠道菌群与癫痫之间可能的联系。本文介绍了微生物-肠-脑轴，综合既往研究中已知的肠道微生物群在癫痫发病和治疗中的作用，为探讨基于肠道微生物群的癫痫治疗新方案提供参考。