When and how should we treat epilepsy in children?

This article draws on recent guidelines and evidence to briefly look at the diagnosis (and misdiagnosis) of epilepsy in children and aims to address the issue of when to treat, when not to treat and how to treat epilepsy by seizure and syndrome type with the use of illustrative cases.Key to the management of epilepsy is individualizing treatment, taking into consideration not only seizure type or epilepsy syndrome but also co-medication, co-morbidity, lifestyle factors, and the preferences of the child and family.Anti-epileptic drugs frequently have adverse effects and it is imperative to consider the risk versus benefit balance for each child.