The treatment for epilepsy patients with intellectual disability is the same as that for patients without intellectual disability. However, some epilepsy patients with intellectual disability are difficult to diagnose, and there is a higher frequency of difficult-to-treat epilepsy and different side effects. It is important to clarify the type of targeted "seizure", and to consider how the "seizure" affects the quality of life (QOL) of the patients and caregivers. Monitoring for side effects of antiepileptic drugs as well as enhancing seizure control will improve the QOL of epilepsy patients and their caregivers. As aggressive behavior was found to be associated with a low QOL of caregivers, greater importance should be placed on psychiatric side effects. Patients with epilepsy and intellectual disability tend to be more aggressive and overweight, and have less weight loss induced by antiepileptic drugs than patients without intellectual disability. For mentally vulnerable patients, antiepileptic drugs with mood stabilizing effects or those with a low risk of psychiatric side effects are recommended. Recently, the understanding of epilepsy syndrome and etiology has been emphasized. When the effects exceed the risk, drugs can be selected based on epilepsy syndrome or etiology even if they have a higher risk of side effects.
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