and seizures. (5) Children’s brains are immature and prone to epilepsy comorbidi­ties. Children have a greater risk of developing neurodevelopmental disorders and mental disorders, especially some patients with epilepsy syndromes such as LKS, infantile spasm, and Dravet syndrome, which often lead to intellectual delay, learn­ing disabilities, cognitive disorders, language development disorders, attention de­cit and hyperactivity disorders, autism spectrum disorders, emotional disorders, depression, etc. Some ASMs may cause or aggravate cognitive impairment, so timely identication and the development of appropriate, comprehensive treatment plans can help improve prognosis. 6) Refractory epilepsy is characterized by diverse seizure types, and complex seizures are liable to lead to sudden death in patients with epilepsy. (7) Some refractory epilepsies, such as LGS, often require multidrug combination treatment, so patients are prone to more cognitive disorders, behavioral abnormalities, excessive sedation and other side effects. In addition to controlling seizures, we should also consider minimizing drug-related side effects and improv­ing overall quality of life. Some types of epilepsy, such as self-limited epilepsy, have a good long-term prognosis and do not require long-term ASM treatment. Therefore, when selecting ASMs for children with epilepsy, in addition to following the ILAE treatment guidelines, special attention should also be given to (1) atypical seizures combined with clinical seizures and EEG changes to correctly determine the type of seizures to guide medication. Valproate and topiramate are preferred for patients with multiple seizure types or those with unclear seizure types [29, 31]. (2) Epilepsy in children mostly manifests as epilepsy syndrome. The clinical diagnosis of epilepsy syndrome in children should be made as clear as possible, and individu­alized treatment should be implemented according to the outcome of epilepsy syn­drome. For example, most cases of self-limited epilepsy with centrotemporal spines have a good prognosis, and the time to start treatment should be determined after a full assessment of benets and risks and full communication with the patient’s par­ents. Carbamazepine, oxcarbamazepine, and levetiracetam can be selected as rst­line treatments [31]. Most patients with epileptic encephalopathy are drug resistant, and treatment should be initiated after the rst seizure. In addition to commonly used ASMs, other therapeutic drugs may also be needed. For example, valproic acid and clobazam can be used as rst-line therapeutic drugs for Dravet syndrome, and fenuramine and stipentol can be recommended as second-line drugs if they are ineffective [32, 33]. ACTH is the rst-line treatment for infantile spasms, and glu­cocorticoids and aminohexanoic acid can also be used as rst-line drugs. When rst-line drugs such as valproate and lamotrigine fail to treat Lennox–Gastaut syn­drome, topiramate, and cannabidiol can be considered additional therapies [33–35]. (4) The genetic etiology of epilepsy plays a prominent role in childhood epilepsy, and the implementation of precise treatment has become the preferred direction for the treatment of childhood epilepsy syndrome. Aminohexenoic acid is preferred for the treatment of infantile spasms with tuberous sclerosis; sodium channel dysfunc­tion caused by SCN2A gene variation is related to the age of the children. Epilepsy occurring before 3months of age is mostly related to variations in sodium channel function. Sodium channel blockers such as phenytoin, oxcarbazepine, and

it may cause neurotoxicity or cognitive impairment. In the presence of these dis­eases, the treatment of senile epilepsy must take into consideration comorbidities and combined drugs. These factors make the treatment of epilepsy in elderly indi­viduals particularly challenging [50].