Until recently, epilepsy medical therapy is usually limited to anti-epileptic drugs (AEDs). However,
approximately 1/3 of epilepsy patients, described as drug-resistant epilepsy (DRE) patients, still suffer from continuous
frequent seizures despite receiving adequate AEDs treatment of sufficient duration. More recently, with the remarkable
progress of immunology, immunity and inflammation are considered to be key elements of the pathobiology of epilepsy.
Activation of inflammatory processes in brain tissue has been observed in both experimental seizure animal models and
epilepsy patients. Anti-inflammatory and immunotherapies also showed significant anticonvulsant properties both in
clinical and in experimental settings. The above emerging evidence indicates that modulation of immunity and
inflammatory processes could serve as novel specific targets to achieve potential anticonvulsant effects for the patients
with epilepsy, especially DRE. Herein we review the recent evidence supporting the role of inflammation in the
development and perpetuation of seizures, and also discuss the recent achievements in modulation of inflammation and
immunotherapy applied to the treatment of epilepsy. Apart from medical therapy, we also discuss the influences of
surgery, ketogenic diet, and electroconvulsive therapy on immunity and inflammation in DRE patients. Taken together, a
promising perspective is suggested for future immunomodulatory therapies in the treatment of patients with DRE.