Due to the complex and diverse manifestations of epilepsy and the lack of basic skills in the diagnosis of epilepsy, misdiagnosis and underdiagnosis of epilepsy are common in clinical practice. Lack of knowledge about epilepsy, not considering some minor seizures, such as fainting, as a “disease”; lack of careful physical examination and neglect of signs with etiologic diagnostic value, such as metabolic diseases often combined with advanced mental retardation and motor disorders, which may lead to missed diagnosis and misdiagnosis if not carefully examined. If the physical examination is not done carefully, the diagnosis may be missed, misdiagnosed and the seizure typing is wrong, which delays the treatment. Therefore, the physician must take a careful, objective and targeted history and help the patient and family to recall the seizure performance, and it is generally best to take a history of at least 20-30 minutes per person for the first time. At the same time, a careful and accurate physical examination should be performed to detect some of the causes of symptomatic epilepsy. ②EEG diagnostic errors and non-standardized mapping and inadequate content Due to the lack of solid basic skills, it is common for someone to mistake the presence of apical spike waves in the sleep EEG for epileptic discharges; the lack of necessary evoked tests results in some epilepsies that are only or easily seized in sleep, such as persistent spike-slow wave epilepsy with sleep slow wave phase (CSWSS), benign childhood epilepsy with central-temporal spikes ( BECCT) and partial frontal lobe epilepsy are often underdiagnosed due to lack of sleep EEG. The appropriate evoked methods and examinations are added for different seizure types and syndromes, such as drug-induced (chloral hydrate) sleep for those epilepsies that are only or easily seized during sleep, or even nocturnal sleep monitoring; hyperventilation for childhood apoplexy; and flash stimulation for photosensitive epilepsy. In addition, pterygoid electrodes are an essential screening tool for temporal lobe epilepsy and can increase the positive rate of scalp EEG by 30-40%. Sometimes some seizure disorders, especially sleep disorder disorders, dystonia disorders and abnormal movements in childhood, are not easily distinguished by clinical manifestations alone, when EEG abnormalities are necessary for diagnosis. If the EEG is not looked at, it is bound to cause misdiagnosis or missed diagnosis. Some seizure types are easily confused, for example, when children with anhedonia with automatism are easily misdiagnosed as complex partial seizures (CPS), which can only be differentiated by EEG, and if the treatment is selected according to CPS, the choice of carbamazepine is bound to aggravate the anhedonia. Therefore, it is impossible to make a correct diagnosis and treatment of epilepsy without being familiar with EEG expertise. ④ Neglecting the diagnosis of etiology Epilepsy is divided into idiopathic and symptomatic epilepsy, and epilepsy caused by organic brain lesions accounts for a significant proportion of epilepsy, so first-time epileptic patients should routinely have imaging examinations to further search for etiology in order to treat epilepsy while targeting the cause. In terms of examining structural lesions, cranial MRI is significantly more sensitive than CT (except for calcifications). If medial temporal lobe epilepsy is considered, hippocampal phase should be added, and hippocampal magnetic resonance proton spectroscopy imaging (1HMRS) can be added if available. In addition, it is not right to delay treatment by overemphasizing the etiologic diagnosis. The diagnosis and treatment of epilepsy is extremely complex, and to avoid misdiagnosis and omission, patients are cautioned to go to a regular hospital to see an epilepsy specialist.