Current status of epilepsy: There are about 50 million people with epilepsy worldwide, 80% in developing countries, of which 80%-90% do not receive appropriate treatment or no treatment at all. Asia accounts for 1/2 of the world, and there are about 9 million people with epilepsy in China, and there are more than 450,000 new cases each year. There are currently about 6.5 million people with active epilepsy in China, with about 2/3 of them in rural areas. The prevalence of epilepsy is 5‰-8‰, meaning that there are 5-8 epileptics in every 1000 people in the normal population. The number of new epilepsy cases is 50-70 per 100,000 each year. children belong to the high prevalence group of epilepsy. the prevalence of children under 10 years of age is quite high, reaching 150 per 100,000 each year. Definition: As we all know, the brain is the “command” of the whole body, and different parts of the brain have different roles and manage different functions of the body. The brain’s function of receiving information and outputting commands is mainly achieved by receiving and sending biological signals. When the brain is dysfunctional, the brain cells become overly discharged in one bed. This excessive abnormal discharge. This excessive abnormal discharge manifests clinically as seizures. The different sites of brain stimulation and the different pathways by which the abnormal over-discharge spreads to the periphery will manifest as different forms of seizures. The clinical manifestations of epilepsy are sudden loss of consciousness, falling to the ground, twitching of limbs, salivation or screaming, etc. After awakening and recovery, the seizure is the same as a normal person, which is commonly known as “jerking the goat’s horn” or “jerking the wind”. There are also some uncommon manifestations such as hallucinations, vomiting, nameless fear, numbness in the limbs, frequent blinking, etc., which may be the aura of epilepsy or seizure symptoms, so any factor that produces abnormal stimulation of the brain may lead to epileptic seizures. Frequent seizures can cause progressive brain dysfunction and affect higher intellectual activity, called epilepsy. The causes of epilepsy: generally speaking, as long as the diseases affecting the brain are likely to cause seizures, the common clinical causes are the following: brain developmental disorders 1, brain malformations 2, neuronal ectopia 3, vascular malformations infection 1, bacterial meningitis 2, tuberculous meningitis 3, mycobacterial meningitis 4, brain abscess 5, herpes simplex virus encephalitis 6, arbovirus 7, subacute sclerosing holoprosencephalitis 8. Human acquired immunodeficiency syndrome Parasites 1, brain-type lung flukes 2, schistosomes 3, cerebral cysts Cerebrovascular diseases1, cerebral infarction2, cerebral hemorrhageTraumatic brain injury1, the incidence of epilepsy after mild traumatic brain injury is 0.7%2, moderate traumatic brain injury is 1.2%3, the incidence of epilepsy after severe trauma is 10%Chronic tumors1, metastatic tumors, sarcoma, lymphoma2, gliomaGenetic and chromosomal dysfunction1, hereditary epilepsy2, chromosomal dysfunctionNeurodegenerative diseasesMultiple sclerosisOther1 The diagnosis of epilepsy requires attention to non-epileptic seizures: although the most common symptom of seizures is convulsions or seizure disorder of consciousness, about 20% of patients who visit epilepsy specialists have non-epileptic symptoms, and non-epileptic seizures are more common than epileptic seizures and can occur in all age groups. Non-epileptic seizures are more common than epileptic seizures and can occur at all ages. However, both non-epileptic seizures and epileptic seizures have seizure characteristics, and clinically, the presentation of seizures is sometimes very similar to that of epileptic seizures and can be very confusing. Therefore, differentiating between seizures and non-epileptic seizures is an important part of epilepsy diagnosis. If the diagnosis is not epilepsy treatment for the appropriate disorder should be performed as soon as possible. How do I choose a treatment? The current treatment for epilepsy is mainly based on medication, surgery and neuromodulation therapy. First, drug treatment should be carried out systematically and regularly under the guidance of a specialist. The general principles of epilepsy treatment with drugs are: early medication, sufficient dose, accurate medication, and long duration. Once the diagnosis of epilepsy is established, medication should be taken immediately to control seizures. The dose is sufficient to control seizures without drug toxicity, and if necessary, blood levels can be checked. The choice of medication is determined according to the different types or syndromes of epilepsy. For the use of surgery for epilepsy treatment, patients who must meet the following points can be considered: i. Drug-refractory epilepsy; ii. Some patients cannot tolerate the severe toxic effects of the drugs, although the seizures can be controlled by high doses, or a combination of multiple antiepileptic drugs, up to 12 times per year. These patients need to be considered for surgical treatment if they have a clear confined epileptic focus; iii. Symptomatic epilepsy with a clear intracranial lesion generally requires surgical treatment. Although some patients with epilepsy can control their seizures through surgery, there are some patients with refractory epilepsy who cannot achieve the desired results even with surgery; in some cases, not only can they not be controlled or cured, but also bring about some other new problems. This is the time to consider neuromodulation techniques, which mainly include deep brain nucleus electrical stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (rTMS). The main application in the treatment of refractory epilepsy is vagus nerve stimulation.