In general, patients whose seizures can be completely controlled by regular antiepileptic medication, or whose seizures are not severe enough to work and live normally even if they occur occasionally, do not need to consider surgery. The majority of patients with epilepsy (60-70%) fall into this category. The medical term “medically refractory epilepsy” generally refers to patients with frequent seizures after more than 2 years of ineffective regular medication. The meaning of “frequent seizures” here is also changing. In the past, due to backward examination methods, low level of epilepsy surgical treatment, low experience, high risk, and strict indications, it generally refers to more than 4 seizures per month. In recent years, surgical techniques have improved rapidly and the risks are becoming less and less, so more patients can receive safe and effective surgical treatment, so the meaning of “frequent seizures” generally refers to more than one seizure per month or more than 10 seizures per year. However, this is not absolute, and some types of epilepsy with clear foci may be operated on as early as possible, especially in adolescent patients, if the number of seizures is small, but it is not expected to be fully controlled by medication in the future, and surgery is expected to be effective. To some extent, the number of seizures is an important factor in considering whether or not to operate, but it is worth noting that often patients and families refer to seizures as “falls and generalized convulsions”. For example, a brief froth, a sudden stop of movement, or a fall of an object, even if it lasts only a few seconds, is called a seizure, and its danger is easily overlooked. It is also worth noting the severity of the seizures. Some people may have only 1-2 seizures a year but exhibit a very severe persistent state, or have severe generalized convulsions that often result in fractures or dislocations, which should be given due consideration when discussing surgical indications. If prolonged seizures are producing or are about to produce severe psychosocial problems, surgery should be considered as early as possible. For example, temporal lobe epilepsy in adolescents often causes language and cognitive impairment, depression, anxiety, poor psychological adjustment, and social isolation, which are reversible in the early stages but gradually become irreversible as seizures persist, eventually seriously affecting school employability and marital status. National and international studies have come to similar conclusions.