Epilepsy is a chronic disease in which sudden abnormal discharges of neurons in the brain cause transient brain dysfunction. What is it like when you have a seizure? A seizure is particularly frightening, with generalized convulsions and foaming at the mouth. This kind of confusion, twitching of the limbs, rolling of the eyes, foaming at the mouth, and in some cases, incontinence, is one of the major seizures, which is called generalized tonic clonic seizures. Another situation is when the patient is doing something suddenly interrupted, stopped, the patient himself is not clear, only a few seconds a dazed child. For example, when you are eating, chopsticks and bowls may fall down, this situation is called a seizure of disorientation, also called a petit mal seizure. This is also called a petit mal seizure. Combined with the above, it is called a generalized seizure. During a seizure, one is not conscious. In real life, when you see a person’s hand or foot or arm suddenly twitch up, or some part of the body feels very numb, the person’s mind is clear and he wants to control the matter, but in fact, he cannot control the symptoms, although his consciousness is clear. This situation is called simple partial seizure. There is another situation where the patient feels like dreaming during the seizure, and what he/she does is not known to him/her, and it is inexplicable and not clear to others, sometimes accompanied by other situations such as fear, hallucination, etc. This situation is called complex partial seizure. This condition is called a complex partial seizure. It is also called a psychomotor seizure because it is mainly a mental disorder with impaired consciousness. These seizures are usually located in the temporal lobe, so they are also called temporal lobe epilepsy. It is collectively called partial epilepsy, along with the previously described conditions. Why does epilepsy have these many and varied manifestations? This is the characteristic of epilepsy. Epilepsy is a chronic brain disease that is mainly due to the dysfunction of the central nervous system caused by excessive discharge of nerve cells in the brain. This neurological disorder is characterized by sudden, recurrent seizures, sometimes several times a day or once every few days, and in addition is brief, lasting from a few seconds to a few minutes. EEG is preferred for epilepsy Symptoms are a very important basis for diagnosing epilepsy, and some tests are needed to confirm whether it is epilepsy. Since epilepsy is an excessive discharge in the brain, it can be recorded by EEG, so the preferred test for epilepsy is EEG. As an outpatient EEG is a little more screening, if it is determined that the patient has epilepsy and it is not captured for a long time it will come to the ward, this is to further confirm the diagnosis. The other key thing we do with the video is to see if the patient has seizures, and the symptoms of the seizures are very helpful in determining if they are epilepsy and what type of epilepsy they are. For example, this patient has been having seizures for more than 10 years, but his imaging (MRI) is normal, but we can see by EEG that he had grand mal seizures at the same time during the 24 hours we monitored, and there are also full-conducting spikes in EEG, now we can see that the EEG when calm has more slow waves but no obvious spikes, now the patient starts to have no clinical seizures but from Now we can see that the patient has no clinical seizures but there is already a significant high amplitude spike-like discharge in the EEG. What we see next is the patient’s clinical seizures. After it is determined to be operated, intraoperatively we are not monitoring the whole brain, just one surgical site, that is, the exposed site. Nowadays, whether it is outpatient or ward, video EEG or general EEG is done on the scalp, intraoperatively it is necessary to open the scalp and skull, and then the electrodes are placed directly on the cortex. This monitoring is much more precise. It is then possible to guide the management of the epileptic focus. Treatment of epilepsy For those with clear lesions that can be treated by surgery, surgery can be applied. For patients with no localized lesions, most patients who cannot be treated surgically should be treated with medications. The principle of drug treatment is from small to large doses, but the specific situation needs to be analyzed. The first choice is to use the drugs alone, and then to consider the combination of drugs. The drug concentration should be measured regularly. It should also be combined with auxiliary tests such as EEG. It is also important to communicate with the doctor regularly. Patients are usually not sure how to treat themselves and should go to the hospital under the guidance of a doctor. In general, if it is secondary epilepsy, we first use surgery to remove the lesion and then most patients will have good results. For primary epilepsy, we first use medication systematically for 2 years and then consider surgery if the medication control is not satisfactory. The diagnosis of epilepsy must be made in a regular hospital with a variety of diagnostic equipment and follow the doctor’s advice so that the correct diagnosis of epilepsy can be made.