The worst approach to patients with LGS is one of pessimism, considering that the prognosis is deﬁnitively catastrophic. On the other hand, the reverse attitude with iterative aggressive treatments should also be avoided. A better strategy is to explain regularly to the family that the aim of the treatment is to suppress the most severe seizures, to avoid additional comorbidities and to avoid heavy poly- therapy. The situation has to be regularly re-evaluated. As LGS is rare, case reports of atypical or unusual treatments may help other clinicians in deciding what type of treatment to use in difﬁcult cases. Disclosures The has no conﬂicts of interest to disclose. References Aarli JA. 2000. Epilepsy and the immune system. Arch Neurol, 57:1689–92. Aarli JA, Fontana A. 1980. Immunological aspects of epilepsy. Epilepsia, 21:451–7. Al Ajlouni S, Shorman A, Daoud AS. 2005. 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