ReviewUntangling the pathomechanisms of temporal lobe epilepsy-The promise of epileptic biomarkers and novel therapeutic approaches

•Proper EEG analysis may provide putative biomarkers of the disease progression.•Neurobehavioral comorbidities can be predictive for the epilepsy outcome.•Gene therapy interventions may yield promising results in focal epilepsies.•Novel therapies targeting hippocampal reorganization may block epileptogenesis.•The scarcity of validated biomarkers hinders the development of curative measures.

Epilepsy is one of the most common neurological diseases and it is characterized by the reoccurrence of seizures with variable severity and frequency. The burden of epilepsy, however, is more than having seizures, as the disease is frequently associated with comorbid cognitive and behavioral disorders. Diagnosis as well as treatment suffers both from the inadequate understanding of the underlying epileptogenic molecular, cellular and network mechanisms and the related lack of reliable biomarkers for the development, progression, or even the presence and severity of the epileptic condition. Here we summarize the recent advances in both clinical and experimental approach regarding epilepsy, which may create the premise for identification of clinically useful, reliable biomarkers. Identification of the basic pathomechanisms of epileptogenesis and epilepsy would potentially create new therapeutic approaches that could not only treat but also prevent and cure epilepsy. Current knowledge regarding the electrophysiological alterations as well as the underlying cellular and molecular mechanisms regarding temporal lobe epilepsy is also critically scrutinized.