Three large studies, all including more than 60 children, on the efficacy on gamma-vinyl GABA (vigabatrin, GVG) in the treatment of childhood epilepsy have been reviewed. On the basis of these and other studies, we conclude that (a) GVG is a promising drug for the treatment of childhood epilepsy, (b) GVG is effective both in partial and generalized epilepsies, (c) GVG seems to be effective in the treatment of symptomatic infantile spasms, (d) no clear dose-response relationship has been demonstrated, (e) a dose of 40-80 mg/kg/day is recommended, and (f) although tolerance is excellent, hyperactivity seems to occur more frequently in children than in adults.