Traditionally treatment of epileptic seizures has been symptomatic, namely medication has been targeted at raising the threshold to the occurrence of epileptic seizures. This has had little impact on the rate of drug resistance over time, or impact on comorbidities such as learning and behaviour particularly in the early onset epilepsies. The advent of advanced neuroimaging and genomics has revealed the cause of the epilepsy in a much higher percentage, and advanced our knowledge as to the underlying pathophysiology. This has given us the opportunity to turn to the possibility of interventional treatment, targeting the underlying cause, and consequently the possibility of changing the natural history of disease. Here we review the options open to us, and the evidence to date.

中文翻译：

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疾病修饰的概念

传统上癫痫发作的治疗是对症治疗，即药物治疗的目标是提高癫痫发作发生的门槛。随着时间的推移，这对耐药率几乎没有影响，或者对学习和行为等合并症的影响很小，尤其是在早发性癫痫中。先进的神经影像学和基因组学的出现以更高的比例揭示了癫痫的病因，并提高了我们对潜在病理生理学的认识。这使我们有机会转向介入治疗的可能性，针对根本原因，从而有可能改变疾病的自然史。在这里，我们回顾了可供我们选择的选项以及迄今为止的证据。