Recommendations for malaria prophylaxis must balance the risk of malaria against the risk of side effects of malaria prophylaxis. In patients with epilepsy, the risk of inducing epileptic fits must also be considered. Mefloquine has been shown to have proconvulsive effects and induce seizures. For other drugs like atovaquone-proguanil, the experience up to now is insufficient in epileptic patients. Considering this balance of risk vs benefit, recommendations are given for malaria prophylaxis in patients with epilepsy.