West-Syndrome is an age-dependent early epileptic encephalopathy manifesting during the first year of life. It carries a high risk for an unfavourable longterm prognosis, especially for the prevailing group of patients with the symptomatic form. Etiologically associated factors are heterogeneous. Among them fetal developmental defects and perinatal hypoxic-ischemic complications predominate. Infantile spasms difficult to control and early manifesting defects in social and communicative capacities determine the poor outlook for longterm mental prognosis. Benefits and risks of currently used anticonvulsant medication are discussed. The need for systematic multimodal longterm care is stressed.