Known as benign epilepsy with central temporal spikes in children, but not always benign, there may be 15% of children with medically refractory, sleep-phase ESES discharges with negative myoclonus, atypical disorientation, and other seizure forms. Parents are always very anxious about such patients because their children also regress in cognitive function and are hyperactive and cranky. First, if you are taking carbamazepine or oxcarbazepine, it is recommended to switch to Depakene in a hurry, and if Depakene is not tolerated, try switching to Kaipulan. Second, methylprednisolone shock therapy, but some children with combined high-frequency discharges on central middle temporal spikes are not effective against hormones. Third …… at this point, if still ineffective, both doctor and patient are at a loss. Ketogenic diet? VNS is too expensive and not cost-effective. Some people even choose open-heart surgery, which is simply a straw man. In my experience, this third step, or even the second, is not to shock the hormones, but to go directly to rTMS, which is repeated transcranial magnetic stimulation. Maybe just 5 treatments, the child has significantly fewer seizures, improved personality, cognitive level, and the maintenance time is at least 3 months, greatly reducing the adverse reactions brought by drugs and hormones, and its low price. Sanbo Brain is probably the first hospital to treat refractory BECT or BECT variants with rTMS. The treatment parameters are critical and not as simple as one might think, and once the stimulation site and frequency are not right, the consequences can be disastrous, so patients must choose the most professional medical team.