Researchers identified a distinct microglial state associated with drug-resistant epilepsy in temporal lobe tissue with hippocampal sclerosis. The study reported a C1Q/antigen-presentation-like microglial reconfiguration that differs from a uniform inflammatory activation pattern. The reported state shift reframes how immune-cell biology may contribute to refractory seizures, supporting a more granular view of microglial programs rather than treating neuroinflammation as a single process. For translational research, the work points to microglial state markers as candidate targets for biomarker development and for future intervention strategies tailored to the refractory disease biology.