In clinical practice, children with many years of epilepsy history are often encountered, and due to the limited awareness of parents and physicians, epilepsy is often found without a comprehensive examination, especially head imaging, and is treated as a matter of course according to primary epilepsy, resulting in poor symptom control, severe intellectual impairment, large drug reactions, poor quality of life, and a high economic and mental burden on the child and family. In a significant proportion of these cases, the children are found to have some structural changes on subsequent imaging, meaning that they are all secondary epilepsy and can be considered for early surgical treatment instead of taking medication for so many years. Why is epilepsy common in childhood? This is mainly related to the growth and developmental characteristics of children. Children are prone to cerebral hemorrhage and cerebral hypoxia at birth, vascular occlusion after trauma during growth, or birth with congenital brain malformations, and some benign tumors. These factors are all predisposing factors for epilepsy in children. I have encountered several cases of childhood epilepsy with a history of seizures for more than 10 years, who have been taking antiepileptic drugs with poor results, but never had a CT or MR taken of the head. It is recommended that the films reveal the presence of benign tumors, hemispheric softening and cortical dysplasia in the skull, which are suitable cases for surgery and have good results, and if the problem could have been detected earlier by examination, such a long process. Therefore, it is highly recommended that children with seizures have a CT or MR of the head, or even some special sequences, from the very beginning, so that early detection and early effective treatment can be achieved. Childhood epilepsy is the main body of the epilepsy population, and for primary epilepsy, about 20% are drug refractory, forming intractable epilepsy, especially catastrophic epilepsy, leading to developmental delay and intellectual impairment in children. Therefore, it is also necessary to adopt surgical methods to alleviate or control seizures in children who are resistant to antiepileptic drugs and whose condition is progressive or even catastrophic, in order to reduce the adverse effects of long-term and frequent seizures.