Eleven institutionalized children (7 girls, 4 boys) with refractory epilepsy received fenfluramine as add-on therapy. Besides therapy resistance, the patients manifested self-induction of seizures. Eight patients were photosensitive and/or pattern sensitive. All antiepileptic drugs of doubtful efficacy were withdrawn. During withdrawal, patients did neither improve nor show an increase in seizure frequency. Fenfluramine was then added and administered once to three times daily at dosages between 0.5 and 1 mg/kg.day. Side effects were mild and transient. Of the 11 patients, 7 became seizure-free and in 4 patients a more than 75% decrease of all seizures was obtained.