The decision to treat and the choice of the right antiepileptic drug depend on frequency, severity, type of seizures, epileptic syndrome, familial and school life, impact of seizures. On the other hand it is important to know the pediatric characteristics of pharmacology, tolerance, possible side effects and efficacy of each antiepileptic drug. Some antiepileptic drugs could also worsen some types of seizures. Other therapies can be efficient in refractory epilepsies: steroids, vague nerve stimulation, ketogenic diet and surgery. Clinical informations are essential to appreciate drugs efficacy and safety. Physician could be very important for the social and school insertion of epileptic children.