Abstract
This study presents a comprehensive review and analysis of global research progress over the past 2 decades regarding the molecular mechanisms underlying acupuncture therapy for epilepsy. Our findings demonstrate that acupuncture, through single or combined acupoint stimulation (including but not limited to GV14, GV20, GV24, ST36, LI11, and ST37), exerts antiepileptic effects primarily by modulating key signaling pathways: PI3K/Akt, TLR4, NF-κB, mTOR, MAPK, BDNF/TrkB, and Nrf2/ARE/HO-1. The therapeutic mechanisms involve suppression of neuroinflammation, mitigation of oxidative stress, inhibition of neuronal apoptosis, regulation of neurotransmitter balance, and restoration of synaptic plasticity, collectively contributing to the reestablishment of excitation/inhibition homeostasis in the central nervous system. These findings establish an "acupoint-pathway-effect" regulatory network, highlighting acupuncture's unique advantage as a multi-target, multi-level therapeutic approach for epilepsy management.