Principles of post-operative medication in epilepsy When I go out of epilepsy surgery clinic, I often meet patients with the question: I have no seizure for 6 months after the surgery, no seizure for 1 year… What a relief, I don’t want to take medication anymore! Or during the preoperative evaluation, patients and family members often ask: After I have the surgery, will I never have to take medication again? I would like to start by saying that, after scientific evaluation, some patients with drug-refractory epilepsy can be cured by surgical treatment (no seizures after surgery). However, human medicine does not know enough about the brain, and the pathogenesis of epilepsy is not clearly explained. So, how long do you take them? What are the criteria for dose reduction and discontinuation? The following points should be noted in the postoperative medication of epilepsy: 1. The postoperative medication is basically based on the preoperative medication Doctors, in principle, will choose a regular antiepileptic treatment plan based on the preoperative medication plan. If the preoperative medication is too much, it can be reduced or reduced under the guidance of the doctor to minimize the toxicity and side effects of antiepileptic drugs. The actual fact is that you can’t be a good candidate for the job. 2, postoperative patients adhere to long-term medication There is no doubt that ILAE clearly suggests that postoperative patients should adhere to long-term, regular medication, regardless of whether they have seizures, and generally take antiepileptic drugs for at least 2 years. During the 2-year period, the video EEG should be reviewed at least once every 6 months. If it is determined that there is no seizure for 2 years and the EEG review is normal for 2 years, the dosage can be gradually reduced under the guidance of the doctor. However, the 2 years mentioned here is a minimum concept. 3. Discontinuation of medication must be carried out slowly The change of medication dose must be slow. Under the guidance of the doctor. Some patients feel that they are “well”, “six months, one year, two years without seizures”, and then suddenly stop the medication on their own, such “spontaneity”, may be replaced by the risk of recurrence of epilepsy. Generally speaking, the medication withdrawal period for epilepsy should be at least 1 year. The dose of medication should be increased or decreased gradually, and should not be stopped suddenly. 4. Pay attention to drug safety Postoperative follow-up with the physician should be maintained regularly. Blood concentration should be monitored to maintain it in a safe and effective concentration range, i.e., to control the epileptic seizures and to avoid toxic side effects as much as possible. In conclusion, surgery is one of the treatments for epilepsy, but it does not apply to everyone, and not everything will be fine if surgery is performed. It is important to adhere to the medication for a period of time after surgery, and then slowly discontinue it under the guidance of your doctor.