One hundred and seventy-three patients with symptomatic and probable symptomatic epilepsies, mean age 31.2 years, were studied. The study included evaluation of anamnesis, clinical and neurological examination, routine EEG and/or video-EEG-monitoring, X-ray CT and/or MRI of the brain. The antiepileptic therapy was corrected. The duration of follow-up study was 2 years. General neurologist therapy (initial therapy) and epileptologist therapy (final therapy) were compared using cost-effectiveness analysis, frequency of using different drugs, ABC- and VEN-analysis. The final therapy was effective in 93.1% of cases, a remission was achieved in 53.2%. The ineffective therapy decreased from 56.6 to 6.9%. The ineffective expenses for the initial therapy were 82.8%. The final therapy was significantly effective (p = 0.001) and expensive (p = 0.004) but the cost difference was low (3420 roubles/year).