Fifty percent of patients with refractory epilepsy are eligible for surgery. Mr. Zhang, who is in his early 30s, has been suffering from epilepsy for more than 10 years. After a detailed consultation with neurosurgeons and neurologists, he was judged to have drug-refractory epilepsy (intractable epilepsy), and his condition was completely controlled after surgery. In fact, there are many examples of people like Mr. Zhang who are eager to seek medical help after suffering from epilepsy and seek medical help indiscriminately. The company’s main goal is to provide the best possible service to its customers. “It is important for epileptic patients to face the disease with a calm mood and correct understanding.” Zhou Dong, chief physician of neurosurgery at Guangdong Provincial People’s Hospital, stressed. He pointed out that according to statistics, the prevalence of epilepsy in China is about 5‰-7‰, and there are 6 million epilepsy patients in China who need long-term medication to control their condition. Among them, drugs are effective for 70% to 80% of patients, and 20% to 30% of patients taking drugs are ineffective or inefficient and belong to refractory epilepsy, but about 50% of patients with refractory epilepsy can undergo surgical intervention, especially adolescent patients who meet the indications for surgery can avoid liver and intellectual developmental damage caused by long-term drug use. Fifty percent of patients with refractory epilepsy are eligible for surgery. Epilepsy is divided into two categories according to imaging anatomy: primary and secondary. The former does not show structural changes in the brain on imaging, but the patient has obvious symptoms and an abnormal EEG. The latter are mostly structural changes, and the causative factors include brain tumor compression, brain softening foci formed after traumatic brain injury, arteriovenous malformations, cavernous hemangiomas, etc. Surgical treatment is preferred. Epilepsy caused by arteriovenous malformations is more common in adolescents. ”Patients with epilepsy can be classified as refractory if they have been taking regular systemic medication for more than two years but have poor results, with an average of more than one seizure per month, or if antiepileptic drugs cause liver and intellectual damage and seriously affect their life and work.” Zhou Dong noted that the cause of drug resistance is not only related to irregular medication, but also to problems with the neurons themselves that form the epileptic foci. ”Refractory epilepsy is also by no means untreatable anymore,” Zhou Dong stressed, “and usually fifty percent of patients with refractory epilepsy meet the indications for surgery.” But in life, many people have fear when it comes to open-heart surgery, thinking that there will be sequelae once the surgery is performed. Zhou Dong said an average of 25,000 to 30,000 epilepsy patients in China need surgical intervention each year, but the annual volume of surgeries nationwide is only a few thousand cases, accounting for less than one-third. “In fact, surgical treatment is an effective and safe method for refractory epilepsy,” Zhou Dong said. Statistics from a large number of cases show that epilepsy surgery has a cure rate of 60 to 80 percent and an efficiency rate of 71 to 95 percent. Preoperative evaluation is crucial “To perform epilepsy surgery, preoperative evaluation is very important – including the determination of surgical indications, feasibility of surgery, selection of surgical approach, and prediction of surgical outcome. This requires a comprehensive assessment of the clinical characteristics of the patient’s seizures, electrophysiological examination (including various EEGs), neuroimaging (CT, MRI, PET, magnetoencephalography), neuropsychology, etc., to lateralize and localize the epileptic focus, and those whose two or more assessment items match are more suitable for surgery.” Zhou Dong cautioned that surgical procedures for epilepsy also carry certain risks. Some patients can develop intracranial hemorrhage and infection, and a small number of patients may exhibit neurological deficits such as altered epilepsy type, memory loss, aphasia and hemiparesis. Nationally, complications are reported to occur in less than 10% and surgical mortality in less than 4%. The formal treatment of epilepsy must be developed through a comprehensive evaluation. These require a high level of examination tools and physician skills, and patients should consider these conditions before choosing a hospital. Postoperative medication should not be taken sloppily There are various types of epilepsy surgery, and the combination of multiple surgical modalities during surgery can improve the surgical results. Intraoperative cortical and deep brain EEG monitoring is important to correct for deviations in extracranial EEG, which is more accurate in determining epileptic foci. Intraoperative cortical EEG monitoring can effectively avoid missing epileptic foci and assess postoperative outcomes, which is also beneficial in improving surgical outcomes. ”Even after epilepsy surgery, it is still necessary to continue taking antiepileptic drugs for a period of time to consolidate the efficacy, usually ranging from six months to two years,” Zhou Dong stressed, adding that if there are no further seizures or only one or two seizures during this period, a gradual reduction in the dosage can be considered until the drugs are completely stopped. Which epilepsy patients are suitable for surgery Patients with primary epilepsy who have been treated with regular systemic medication for more than two years but have poor results, have more than one seizure per month on average, or have liver and intellectual damage caused by antiepileptic drugs, which seriously affects life and work, can have surgery if the epileptic waves are confined to the lobes or one hemisphere of the brain after EEG examination. Secondary epilepsy caused by traumatic brain injury, surgical brain injury, brain tumor, cerebrovascular disease and temporal lobe hippocampal sclerosis (atrophy) are more suitable for epilepsy surgical treatment.