A long-term treatment starts once epilepsy was diagnosed and first medication was given. In addition to seizure cessation, drug choice should orient to avoid various adverse effects in various stages of life. When 2 drugs failed to stop seizures for at least 1 year, other therapeutic options including surgery should be considered before adjusting further medications. Comorbidities such as psychiatric disorders should also be appropriately addressed and treated as well as psychosocial support to improve quality of life. In Japan, an appropriate care system for epilepsy failed. Medical treatment and support network system for epilepsy care, consisting of primary, secondary and tertiary care system, should be established and acknowledged. There should be proper coordinators who connect network systems to function regionally and globally as well as interdisciplinary.