The child was a 5-year-old male. He was admitted to the hospital with “epilepsy” as the main cause of “seizure tetanus with sudden collapse for 5 years”. The child began to have episodes of loss of consciousness, double upward gaze, and tonicity of the limbs for a few seconds for 6 days after birth, without high fever, and was considered to have “viral encephalitis” at the local hospital. He was given “phenobarbital”, which was used in the treatment of the disease. He was treated with a combination of phenobarbital, Depakene, Tolstoy, and Trilogy as single or multiple drugs, and at most three drugs were combined. The child had significantly low intelligence and responsiveness and no active speech. The child’s family had been working in almost every major city in the country while visiting the doctor and had considered surgery, which was rejected because of diffuse EEG changes. Past: full-term caesarean section, no clear history of ischemia and hypoxia, no history of febrile convulsions, and no family history of epilepsy. After admission, cranial MRI (our hospital): 1, left cerebral hemisphere hypoplasia, left parieto-occipital softening foci formation, left lateral ventricle enlargement. 2. right parietal subcutaneous hematoma (recent post-ictal head trauma). Video EEG was monitored for 3 days and more than 10 seizures were recorded, developed as tonic seizures. The interictal period showed emanation or rhythmic emission of all-conductor slow spike and multi-spike slow complex waves. During seizures: full-conductor spike-wave rhythmic bursts lasting 5-7 seconds. The diagnosis was Lennox-Gastaut syndrome, refractory epilepsy. After repeated studies and discussions, we performed radical surgery with resection of the left anterior temporal and left parieto-occipital lobes with multiple lobotomies. One and a half years after the operation, there is no seizure, and what is more surprising is that the EEG has disappeared after the operation, and the background rhythm has improved to 8-9 HZ, compared with 6-8 HZ before the operation. The parents could go to work normally. Epilepsy surgery has been shown to be an effective treatment for patients with refractory symptomatic epilepsy. The goal of treatment is to control seizures, improve the patient’s quality of life and return to society. Especially in children with refractory epilepsy, early surgery can prevent developmental and behavioral impairments caused by the epilepsy itself and abnormal discharges. During the surgical evaluation of epilepsy, surgical treatment is often chosen when there are clear focal abnormal discharges on the EEG during interictal and ictal phases that are compatible with the imaging lesion. If the EEG is a generalized abnormal discharge with mental retardation, surgery is often not considered even if there is a clear imaging lesion. However, in recent years, Gupta et al. reported 10 pediatric patients with refractory epilepsy with generalized or multifocal abnormal EEG discharges in the interictal and ictal phases. 30-100% of the abnormal discharges during the interictal and seizure periods were generalized or surgical contralateral discharges, and 85% of the patients had disappearance or significant improvement of the seizures after surgery. The choice of surgery in this group of patients was based on: (i) the patient’s cranial MRI showed widespread unilateral or markedly asymmetric congenital or early acquired epileptogenic lesions. (ii) Refractory epilepsy. (iii) Low risk of new neurological deficits after surgery, with some patients already having preoperative hemiplegia or focal manifestations.