The drug treatment of severely disabled patients with epilepsy meets particular problems because the subjects are unable to report accurately their symptoms and the possible side effects; furthermore, there is a lack in literature of specific trials. For the first question, the presence of the professional/educator is needed. He is able to report direct and indirect signs of clinical importance, thanks to his continuous contact with the patient . Drugs have to be chosen according to the type of crisis, considering the side effects, that could be severe and irreversible. The paper takes also into account pro and contra of the new antiepileptic drugs, drawing attention also on recommendations reported in some recent works published in "Neurology" and "Seizures". Considering some new researches it also discusses the refractoriness to antiepileptic therapy. The author reports a case of worsening of the epileptic symptoms linked to the use of carbamazepine that in principle was considered suitable for that patient.
Keywords: Disability, epilepsy, antiepileptic therapy, drug-resistant epilepsies