The prevalence of epilepsy in China is 7% and the total number of patients is more than 9 million, which brings heavy burden to the society and family while the patients themselves suffer. At present, many hospitals in China have successively carried out surgical treatment of epilepsy, providing a new treatment for intractable epilepsy, which has been welcomed by patients. Each year, 25,000-300,000 epileptic patients in China need surgery, but only a few receive it, and most of them are treated with low level or even wrong surgical treatment. It is necessary for the epilepsy specialist or neurologist to have an objective come to know about epilepsy surgery to avoid stepping into misconceptions. The key to preoperative preparation is to determine a reasonable surgical plan based on the correct selection of indications, precise localization of the epileptic focus and accurate localization of the functional brain area. I. Principles of surgical treatment of epilepsy Epilepsy is caused by repeated abnormal discharges of brain neurons from various causes, which in turn leads to transient abnormalities in brain function and manifests a series of clinical symptoms. The area of origin and the subsequent path of spread of abnormal discharges in epilepsy lead to a wide variety of clinical manifestations. The abnormal discharges can start in one part of the cerebral cortex, be confined to that area or spread to other areas of the brain. In some cases, although the epileptic focus is clear, complete seizure control cannot be implemented because the epileptic focus is located in an important functional area. At this time, seizure control can also be achieved by surgical methods to block the spread of abnormal epileptic discharges to other brain areas. In other patients with epilepsy, abnormal discharges can start in both hemispheres at the same time, and such abnormal discharges can be the result of the interaction between the two hemispheres, which are mostly clinically manifested as full-blown seizures. At this time, it is impossible to find a single abnormal discharge initiation area, so the epilepsy cannot be treated by removing a single epileptic focus, however, if the connection between the two hemispheres can be blocked to reduce the interaction between the hemispheres, it can To some extent, seizures can be reduced and mitigated. In some primary epilepsies, the abnormal synchronous discharges in both hemispheres are regulated by abnormal pacing points in the deep brain structures, and in such cases, it is not possible to remove the epileptic focus or benefit from blocking the bilateral hemispheric connections. The surgical methods commonly used in epilepsy surgical treatment are divided into three categories: 1) resection of epileptic foci, 2) surgery to block the propagation of abnormal discharges, and 3) surgery to change the excitability of the cerebral cortex. If these lesions are determined to be responsible for epilepsy, the lesions and their associated epileptic foci can be removed. In the absence of imaging changes, cortical epileptic foci should be resected after localization of the epileptic foci. Approximately 60-70% of patients with epilepsy can be cured after surgery. (2) Anterior temporal lobectomy: This is the most used surgical procedure. It can be performed when it is determined that the epileptic focus is located on one side of the temporal lobe. 60% of refractory epilepsies are temporal lobe epilepsies. The anterior temporal lobectomy rarely causes functional brain damage, and more than 80% of patients can have complete cessation of seizures after surgery when the preoperative localization is accurate. (3) Selective amygdala and hippocampus resection: When the epileptic focus is determined to be located in the medial temporal lobe structures, selective resection of the amygdala and hippocampus on one side to avoid damage to the lateral temporal lobe cortex will also have good therapeutic results. Ninety percent of temporal lobe epilepsy is associated with medial temporal lobe structures. The complete control of epilepsy in this procedure is about 40%, and the efficiency is 85%. (4) Cerebral hemisphere resection: it is suitable for those with intractable epilepsy, epileptogenic foci involving most or all of one cerebral hemisphere and the contralateral cerebral hemisphere has functional compensation, epilepsy control, epilepsy control and efficiency is nearly 100%. (2) Surgery to block the spread of abnormal epileptic discharges and the mutual influence of epileptogenic foci (1) Multiple submural transverse fiber cut: surgery to cut the transverse fibers of neurons under multiple soft meninges to block the spread of synchronous neuronal discharges of epileptogenic foci, mainly for refractory epilepsy in important functional areas. (2) Stereotactic surgery: The advantage of this surgery is that it does not require craniotomy and has little loss of brain tissue, but requires high accuracy of localization. The purpose of the surgery is to destroy the nuclei associated with seizures and the nerve fibers spreading by stereotactic surgery, and some refractory epilepsies that are not suitable for craniotomy can be treated with this surgery, lacking efficient reporting. (1) Vagus nerve stimulation: A miniature stimulator is implanted in the subcutaneous tissue of the left clavicle, and electrodes are introduced into the lower part of the neck through subcutaneous tunnels and wrapped around the vagus nerve to change the excitability of neural tissue in the brain by stimulating the vagus nerve to suppress seizures. (2) Chronic deep brain electrical stimulation: special deep brain stimulation electrodes are placed in the anterior and posterior lobes of the bilateral cerebellar cortex or the nucleus accumbens, and the deep brain structures are stimulated by the subcutaneous electrical stimulation device, which changes the propagation of the intracerebral circuit and reduces the excitability of the cortex to reduce seizures. The clinical efficacy can reach 70%. (3) Stereotactic surgery: Under certain circumstances, stereotactic destruction of some nuclei in the brain can achieve similar effects as deep brain stimulation.