There are many causes of epilepsy, mainly congenital genetic factors, perinatal injuries, and developmental malformations in newborns and children; in adults, it is more often due to hippocampal sclerosis, traumatic brain injury, brain tumors, cerebrovascular disease, and central nervous system infections. Therefore, after the diagnosis of epilepsy is determined, the cause should be actively sought and targeted treatment should be carried out according to the symptoms and causes. In general, medication is the most important and basic form of epilepsy treatment. However, in cases where the “responsible lesion” for the seizure can be identified by modern medical tests, even if the seizure can be controlled by medication, there is a high risk of continued seizures after discontinuation of the medication, so surgery should be considered as a priority. These “responsible lesions” include brain tumors, cerebrovascular disease, post-traumatic intracranial foreign bodies, brain softening foci, as well as hippocampal sclerosis and congenital cortical dysplasia. Otherwise, epilepsy should be treated mainly with medication. However, 20-30% of patients with epilepsy that cannot be controlled after correct, regular, and adequate treatment with multiple drugs are considered drug-refractory epilepsy, and surgical treatment should also be considered.