show Abstracthide AbstractPatients with epilepsy are known to have intestinal dysbiosis, which can modulate drug-response and disease outcome. We investigated the composition of the gut microbiota in a cohort of pediatric patients with epilepsy of genetic and presumed genetic etiologies. Through 16S analysis we show that epileptic patients, and in particular those who are drug-resistant, display unique gut metagenomic signatures compared to age-matched neurotypical controls. This study shows that the gut-brain axis can have profound effects on health and disease. The characterization of metagenomic profiles associated with epilepsy could lead to the discovery of novel biomarkers and therapeutic approaches for this multifaceted disease.