Epilepsy is a recurrent seizure status, which occurs commonly in the population. It is a clinical manifestation of a large number of abnormal neuronal discharges caused by different causes, with characteristics such as sudden onset and recurrent seizures. There are about 9 million epilepsy patients in China, and most of them can be controlled through scientific and reasonable drug treatment. However, nearly 1/3 of epilepsy patients have poor results with drug therapy, which is called drug-refractory epilepsy, and most of them are suitable for surgical treatment. The patient in this case is a 16-year-old young male with a 3-year history of epilepsy, who has been taking a variety of antiepileptic drugs and gradually increasing the dose, but with poor results, and has experienced side effects such as hair loss and memory loss, which have greatly affected the patient’s study and life and increased the patient’s family burden. After the patient was admitted to the hospital, we decided to adopt long-range video EEG monitoring for general localization and diagnosis, cranial MRI spectral analysis and PETCT for elevated Cho peaks in the hippocampus, suggesting hypometabolism in the right temporal lobe, and initially determined the epileptogenic focus. After discussion, we decided to use a combination of long-range video EEG and intracranial electrode monitoring of cortical EEG to perform staged surgery. After the patient was admitted to the hospital, the epileptogenic focus was initially determined to be in the right frontal or temporal lobe by combining long-range video EEG and cranial MR. Three subdural strip electrodes were inserted into the subdural area and placed at the correct cortical location and depth after the preoperative precise positioning. After 48 hours of postoperative cortical EEG monitoring, it was determined that the epileptogenic focus in this case was located in the right temporal lobe – hippocampus and belonged to medial temporal lobe epilepsy. Three days after the first operation, the patient underwent a second-stage surgery. The patient entered the operating room for medial temporal lobe resection, which included the middle temporal gyrus, inferior gyrus and right hippocampus. After the operation, the patient was discharged from the hospital, and the dosage of antiepileptic drugs was gradually reduced under the guidance, and now the patient has been followed up for six months without seizures. The neurosurgery department of Qilu Hospital currently has several technologically advanced long-range video EEG monitoring systems, which can monitor the patient’s living status 24 hours a day and accurately capture the abnormal waveforms during seizures and the patient’s mental activity status during seizures. It is a cost-effective method for definitive epilepsy diagnosis and has been applied to more than 20 patients. In cases of refractory epilepsy, especially in adolescents, where there are no obvious intracranial abnormalities on imaging, the diagnosis is not very accurate on the basis of scalp video EEG alone, and can be more accurately localized with the help of intracranially placed electrodes, which are closer to the recorded area and eliminate artifacts from motor and muscle electrical activity. Because intracranial electrodes are invasive, a rigorous preoperative evaluation and initial preoperative noninvasive video EEG monitoring must be completed before the procedure can be performed. Epilepsy surgery is an emerging discipline with multidisciplinary cooperation, requiring the joint cooperation of internal, external, imaging, and neurophysiological disciplines. Our neurosurgery department has established a collaborative relationship with neurology, pediatric medicine, and imaging to work together on the surgical treatment of epilepsy.