Journal of Neurology

, Volume 265, Issue 8, pp 1934–1936 | Cite as

Can epilepsy be treated by antibiotics?

  • Hilde M. H. BraakmanEmail author
  • Jakko van Ingen
Letter to the Editors


There is mounting evidence for the role of the gut microbiota and gut–brain interactions in neurological diseases. We present six patients with drug-resistant epilepsy who attained temporary seizure freedom during antibiotic treatment. The effect on seizure frequency waned within 2 weeks after cessation of antibiotic treatment. We hypothesized that antibiotic treatments may have a short-term effect, through gut microbiota disruption, on gut–brain interactions and ultimately seizure frequency. This observed impact of antibiotics on seizure frequency hints at a possible role of the gut microbiota in epilepsy and its manifestations. This begs the question: can epilepsy be treated by antibiotics? Or perhaps in a broader sense: can alterations in the gut microbiota be used as a treatment modality in drug-resistant epilepsy? This concept and the six intriguing cases provide interesting leads for epilepsy management.


Microbiome Epilepsy Ketogenic diet Antibiotics 



No external funding was obtained for this study.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.


  1. 1.
    Kwan P, Schachter SC, Brodie MJ (2011) Drug-resistant epilepsy. New Engl J Med 365:919–926CrossRefPubMedGoogle Scholar
  2. 2.
    Supuran CT (2016) Drug interaction considerations in the therapeutic use of carbonic anhydrase inhibitors. Expert Opin Drug Metab Toxicol 12:423–431CrossRefPubMedGoogle Scholar
  3. 3.
    Tremlett H, Bauer KC, Appel-Cresswell S, Finlay BB, Waubant E (2017) The gut microbiome in human neurological disease: a review. Ann Neurol 81:369–382CrossRefPubMedGoogle Scholar
  4. 4.
    Xie G, Zhou Q, Qiu CZ, Dai WK, Wang HP, Li YH et al (2017) Ketogenic diet poses a significant effect on imbalanced gut microbiota in infants with refractory epilepsy. World J Gastroenterol 23:6164–6171CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Olson CA, Vuong HE, Yano JM, Liang QY, Nusbaum DJ, Hsiao EY (2018) The gut microbiota mediates the anti-seizure effects of the ketogenic diet. Cell PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Imani S, Buscher H, Marriott D, Gentili S, Sandaradura I (2017) Too much of a good thing: a retrospective study of β-lactam concentration-toxicity relationships. J Antimicrob Chemother 72:2891–2897CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyAcademic Center for Epileptology, Kempenhaeghe & Maastricht UMC+HeezeThe Netherlands
  2. 2.Department of Medical MicrobiologyRadboud University Medical CenterNijmegenThe Netherlands

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