Epilepsy is one of the oldest and most common neurological disorders Epilepsy has a very long history, probably as old as humanity itself. The earliest records of epilepsy originated in ancient Greece 2,500 years ago. Epilepsy occurs in all countries and races, and many famous historical figures, such as Julius Caesar, Joan of Arc, Byron, Nobel, Napoleon, etc., have suffered from epilepsy. According to the latest domestic statistics, the prevalence of epilepsy in China is 0.7%, according to which it is estimated that there are about 9 million epilepsy patients in China, while the number of new patients increases by about 400,000 every year. Epilepsy has become the second most common disease of the nervous system after headache. In fact, epilepsy is not as terrible as it is thought to be, and reasonable medication is the preferred and effective treatment option. Approximately 60%-80% of patients with epilepsy can have their clinical seizures controlled with conventional antiepileptic drug therapy. Drug therapy is the basic treatment for epilepsy, but several principles should be followed: (1) the diagnosis of epilepsy must be clear, and some non-epileptic diseases should be excluded to avoid misdiagnosis; (2) regular and rational drug use, following the internationally recognized treatment principles and treatment guidelines; (3) individualized drug use, understanding the clinical characteristics, drug response and treatment requirements of each patient; (4) strict drug monitoring to minimize or (4) Strict drug monitoring to minimize or avoid serious adverse reactions and to ensure that drugs are administered in a safe and effective concentration range in the body. The introduction of new antiepileptic drugs over the decades has also brought continuous joy to patients with epilepsy. Drug-refractory epilepsy is a difficult condition to treat and has the greatest impact on patients. About 20%-30% of patients respond poorly to drug therapy, called drug-refractory epilepsy, mainly refers to cases in which two to three antiepileptic drugs or a combination of several drugs are used alone for more than a certain period of time with poor results. Drug-refractory epilepsy has a long course, recurrent clinical seizures, a high disability rate, and often leads to a variety of adverse outcomes such as trauma, traffic accidents, drowning, mental retardation, depression, and so on. The physical and mental health of patients with epilepsy (especially adolescent patients) is seriously threatened, often preventing them from studying, working and living normally, affecting the quality of life of patients and their family members, and increasing the economic burden. Active search for the cause of epilepsy makes surgical cure of epilepsy possible The causes of epilepsy are many and complex. Generally speaking, it can be broadly divided into primary epilepsy and secondary epilepsy. Primary epilepsy is a type of epilepsy that is related to genetic factors and does not have other underlying causes, meaning that the various tests that are currently available have not been able to prove that there is a lesion in the brain that causes seizures. Secondary epilepsy, also known as symptomatic epilepsy, is epilepsy for which a clear cause can be found. Common causes of secondary epilepsy include prenatal or birth injury, craniocerebral trauma, congenital cortical developmental abnormalities, vascular malformations, intracranial infections, brain tumors, cerebrovascular disease, metabolic disorders, poisoning or other causes. With the progress of medical science and the continuous introduction of advanced medical instruments, the detection rate of brain lesions has greatly increased, making it possible to find the cause of some of the epilepsy that could not be found. In the past two decades, high-resolution MRI has gradually been widely used to screen for epileptic lesions and has become one of the most important preoperative tests. A good example in this regard is focal cortical dysplasia. It is now generally accepted that cortical dysplasia is a very common cause of symptomatic epilepsy, but this alteration is not detectable by ordinary head CT, with the possibility of clear visualization by high-resolution MRI. This technological advancement has driven new developments in the surgical treatment of epilepsy. Currently, for patients with seizure foci shown by MRI, the percentage of seizures that disappear after surgery can reach about 75%. Another new technology that is driving the rapid development of epilepsy surgery is the digital video EEG monitoring system. EEG is essential evidence for the diagnosis of epilepsy and for determining the location of epileptic foci. In the past, EEG was drawn directly on white paper by a tracing pen, and usually the recording time was only about 10-20 minutes before a stack of paper was used. The digital EEG is displayed on the computer screen and stored in the hard disk at any time, which can extend the recording time almost indefinitely, so the EEG changes during the whole process of seizure can be recorded. It is also equipped with a digital video recording system that can clearly record every subtle action of the patient’s seizure process. The location of the seizure lesion can also often be determined through a combined analysis of the seizure manifestations and the EEG, which is more necessary for those patients who do not have a clear lesion on the MRI. On top of this, various platinum-inlaid silicone soft electrodes can also be placed directly on the surface of the cerebral cortex or deep in the brain to directly collect information on the origin of seizures and locate the epileptic foci more precisely. Surgical treatment of epilepsy began in 1886 and has been a common dream of epileptologists and neurosurgeons for more than 100 years since then, despite its rise and fall. It was only in the last two decades that advanced medical testing techniques have emerged and the efficacy of epilepsy surgery has become truly compelling, exciting, and even near-miraculous, and epilepsy surgery has reached an unprecedented level of prosperity worldwide. There are a variety of surgical approaches, but currently the only internationally recognized procedure with the most definitive efficacy is epilepsy focal resection. According to the statistics of Beijing Institute of Functional Neurosurgery and Beijing Epilepsy Treatment Center, the cure rate of nearly 800 cases of refractory epilepsy surgery is about 76%, which is encouraging and almost comparable to the international advanced epilepsy centers. We can see that epilepsy, which has plagued mankind for thousands of years, has made many breakthroughs in basic theory and clinical treatment, especially in surgical removal of epileptic lesions, through the unremitting exploration and efforts of several generations in the 20th century. With the continuous updating of therapeutic drugs and the improvement of surgical treatment, epilepsy is not as difficult to treat as it was in the past, but has a much better outcome. We have reasons to believe that the day when human beings will be free from epilepsy is not too far away.