The opportunities for treating epilepsy have improved greatly over recent years because of advances in presurgical investigation and the availability of a number of new antiepileptic drugs. There is a growing awareness of the way in which medication can be used to maximum advantage, minimizing adverse effects, particularly in special groups such as those with learning disability. Genetics is beginning to show promise for the future in relation to the causes of epilepsy, the underlying mechanisms of the condition and the scientific basis for its treatment.