This paper acknowledges that the majority of doctors who care for those with epilepsy are not specialists in epileptology. It then provides standard guidelines to patient management and provides a flow chart for diagnosis, examination, investigations and treatment to assist in decision making. The paper argues that excessively rigid formalized programmes result in loss of flexibility to respond to changing circumstances, which may require further investigation to confirm the diagnosis and the appropriateness of selected therapy. The paper reaffirms that guidelines could cause unnecessary inhibitions to optimal delivery of care but those who deviate from standard practice must be able to substantiate and justify the approach adopted.