First of all, what is “cured”? From the patient’s point of view, it is not difficult to understand, that is, there will be no more attacks, no need for any other treatment such as medication, and no sequelae will be left in the process of treatment. In fact, from the doctor’s point of view, there is no such concept as “cured”, but according to the above explanation, the closer term should be “cured”. Epilepsy is not a disease, it is a manifestation of many diseases, so its diagnosis and treatment is a relatively complex process. In general, as long as there is no misdiagnosis and no indiscriminate treatment, the majority of patients will be treated satisfactorily. That is to say, there are some patients who have had several seizures or frequent seizures over a period of time, but regardless of whether they are treated or not, or regardless of which treatment is adopted and whether the treatment is appropriate, epilepsy can be “cured” and will not have any effect in the future. This is why there are always cases of very good results with unorthodox treatments (even what we sometimes call “charlatans”). I remember looking up an article that reported a 21.4% rate of spontaneous remission. This can be interpreted simply as a transient brain disorder resulting in a seizure that recovers well and is fine in the future. In fact, often people recall that they have had seizures in the past, and they did not pay attention to them and did not treat them, so they are naturally fine. So now that living conditions are better, especially in our country where most are a child, parents are also highly concerned and overly nervous as soon as they find a seizure, which is actually not necessary. There is a similar situation we call “febrile convulsions”, which occurs when a child has a high fever before the age of 2. Nowadays, this condition is not diagnosed as epilepsy, and there is usually no problem in the future. Some of them may develop into seizures even without fever, and need to be treated as soon as possible. There are also some patients with epilepsy whose seizures are clearly age-related, some of which we call “benign epilepsy”, the most common being “benign central temporal epilepsy in children”, but there are also many other types. These seizures are often mild and do not affect mental development, and the MRI of the skull is usually normal. Although some patients seem to have severe EEG, as long as they take regular medication, they are usually treated for 3 to 5 years, and after that age (which varies from type to type), they will naturally not have seizures. In the past few years, we often encountered some patients who had craniotomy in the hospital, but there was no effect, and the final diagnosis was “benign epilepsy”, which will naturally get better after a few years, so surgery is not necessary. The first thing is that the company’s business is not a business. The third is that there are some patients with epilepsy who have a single type of seizure and are only sensitive to a particular drug. That is, as long as the right drug is chosen, they can be completely seizure-free while taking the medication. This requires an experienced physician who can make an early and accurate diagnosis and select the correct medication as early as possible. Of course most of these patients need to take the medication for life and it is the only effective treatment. In fact, it can be treated as “diabetes”, “hypertension” and other diseases, lifelong medication is also, this can also be considered a cure! The fourth is that the patient’s general condition is good, the basic development of intelligence is normal, in the case of regular medication still have seizures, but the degree of seizures is less, the number of less, the impact on life is not great. This kind of patients in the past economic conditions backward, medical level is not high, also rely on drugs to maintain the situation. Now the conditions are better, many patients are still not satisfied with the status quo, always looking for a better way to “cure”, and it is easy to seek medical care indiscriminately. Even in some regular hospitals, doctors try to use surgery to improve the quality of life of the patients when they see that they are desperate. There is a problem of the timing of surgery and the risk of surgery. At present, different regions of China, different hospitals, and even different doctors in the same hospital may have different opinions. The final treatment plan may depend on the magnitude of the surgical risk, the expected efficacy, and the expectations of the patient. The last category is what we call “medication-refractory epilepsy,” meaning that the seizures are not effectively controlled after multiple regular medications and have a significant impact on quality of life. In fact, surgery is not always possible, and according to statistical results, only about half of these “drug-refractory epilepsy” patients can eventually achieve effective results with surgery, so they should not be forced to do so. It is important to note that there is no precise definition of “drug-refractory epilepsy” to date, and it is actually evolving. In recent years, in order to facilitate laymen’s understanding, I have simply summarized it as “3, 2, 1”, which is not accurate and is for reference only. The so-called “3” refers to a medical history of more than 3 years, which means that if the disease is recent and only a few episodes have occurred, surgery is generally not considered. The so-called “2” refers to at least 2 years of regular medication, that is, if you have not undergone systematic medication, you are generally not considered for surgery, so we often encounter patients who are very eager to have surgery but have not taken any medication or have taken medication intermittently before. In such cases, surgery is generally not considered. The term “1” refers to an average of at least one seizure per month or more than 10 seizures per year. Note that there is no difference in size between “seizures” and “grand mal” seizures for doctors. As long as there are seizures, they should be counted. The above “321” statement is just for the sake of understanding, the actual situation is far more complicated, and the patient’s specific situation is also very different. If we wait for more than 3 years, it will delay the treatment of many patients, at least young children under 3 years old, will not be able to operate. In fact, the youngest child I have operated on was less than 1 year old. The trend in the past few years is to operate as early as possible once it is determined that surgery is possible, and the younger the age, the less impact it will have on future life. The role of the doctor is to constantly sum up the experience, to anticipate the development of the disease in advance and to make early decisions in favor of the patient. Therefore, there is actually no strict boundary, and with the continuous development and improvement of medical standards, doctors may make different judgments for the same patient at different times. Especially in the field of epilepsy surgery, China is in the beginning and development stage, and the understanding of the disease and treatment opinions are in progress.