The S2k-Leitlinie der Deutschen Gesellschaft für Neurologie in Zusammenarbeit mit der Deutschen Gesellschaft für Epileptologie provides recommendations for clinically relevant questions in five major topic blocks: Management of the first epileptic seizure, pharmacotherapy, epilepsy surgery, complementary and supportive therapies, and psychosocial aspects. The guidelines cover a wide range of topics, including differential diagnosis of seizures, neuroimaging, neuropsychological screening, and the management of comorbid psychiatric disorders. Key recommendations include the use of lamotrigine as the first-line monotherapy for focal and genetic generalized epilepsy, the importance of considering teratogenic risks when prescribing antiepileptic drugs during pregnancy, and the need for close monitoring of serum drug concentrations to optimize treatment. The guidelines also emphasize the importance of psychosocial support and education for patients with epilepsy, including issues such as driving restrictions, employment, and lifestyle adjustments.The S2k-Leitlinie der Deutschen Gesellschaft für Neurologie in Zusammenarbeit mit der Deutschen Gesellschaft für Epileptologie provides recommendations for clinically relevant questions in five major topic blocks: Management of the first epileptic seizure, pharmacotherapy, epilepsy surgery, complementary and supportive therapies, and psychosocial aspects. The guidelines cover a wide range of topics, including differential diagnosis of seizures, neuroimaging, neuropsychological screening, and the management of comorbid psychiatric disorders. Key recommendations include the use of lamotrigine as the first-line monotherapy for focal and genetic generalized epilepsy, the importance of considering teratogenic risks when prescribing antiepileptic drugs during pregnancy, and the need for close monitoring of serum drug concentrations to optimize treatment. The guidelines also emphasize the importance of psychosocial support and education for patients with epilepsy, including issues such as driving restrictions, employment, and lifestyle adjustments.