The treatment for Aicardi syndrome is based on the clinical and developmental manifestations and may include a number of medical and therapeutic specialties such as pediatric neurology or epileptology, neurosurgery, ophthalmology, orthopedics, gastroenterology, physical therapy, speech therapy and occupational therapy. Treatment of seizures is initiated at the time of onset and often includes ACTH and vigabatrin for the treatment of infantile spasms. As refractory epilepsy continues, placement of a vagus nerve stimulator (VNS) or brain surgery is often considered. Most children are not candidates for brain surgery due to multiple areas of epileptogenesis. Brain surgery, such as hemispherectomy or cortical resection, has been performed in many children with Aicardi syndrome although virtually all continue to have seizures. However, surgery may have provided better seizure control or a temporary period of seizure-freedom, allowing progress in development and/or improved quality of life.