Intracranial electrode monitoring is an important tool for preoperative evaluation in patients with intractable epilepsy that is difficult to precisely locate or in which the epileptic focus is located in an important functional area. Because of the invasive nature of intracranial electrode monitoring, the monitoring process is technically demanding and involves certain risks, and therefore requires a high level of care. We used intracranial electrode placement and localization to treat refractory epilepsy in 32 cases from January 2015 to June 2015, and all patients successfully completed intracranial electrode monitoring and were discharged from the hospital after surgery. The specific summary is as follows: 1. Clinical data and methods 1.1 General data The 32 patients in this group, 18 cases in males, aged 12 to 38 years, with a history of 5 to 14 years. There were 14 female cases; age 9 to 35 years old, with a history of 6 to 18 years. All were refractory epilepsy, and long-term medication could not control the seizures, which seriously affected study, life and work. 1.2 Case selection, scalp EEG pseudo-differential interference, abnormal discharges diffuse; imaging seen lesions and scalp EEG localization inconsistent; temporal lobe epilepsy can not be fixed laterally; epileptogenic foci adjacent to functional areas. 1.3 To examine the method, electrodes were placed on the surface of the brain and in the deep suspicious area of the brain through craniotomy, and the EEG activities of different parts of the electrodes were recorded in the interictal and ictal periods. During the monitoring process, more than 3 habitual seizures were captured as the standard in each case. We did postoperative monitoring, prevention and care of complications, principles of seizure period management, safety care, and application of antiepileptic drugs during postoperative monitoring of 32 patients with refractory epilepsy in our group with intracranial electrode placement. 1.4 Main nursing problems Surgical complications, intracranial and wound infections, cerebrospinal fluid leakage, increased psychological stress, physical injuries due to seizures, electrode displacement or poor contact, etc. 2. Nursing measures 2.1 In the preparation phase, a single room is set up for supervision, and before the patient is admitted, the bed unit is disinfected and the room is disinfected with ultraviolet air; disinfectant solution is prepared at the bedside to facilitate the medical staff and family members to disinfect the patient’s hands before and after the operation. Protect the patient with bed rails to prevent accidents such as knocking, bruising and falling from the bed during seizures. Before monitoring, tell the patient and family to stop all antiepileptic drugs according to the drug withdrawal protocol. Prepare emergency items such as oxygen absorber, sputum suction, dental pad, tongue depressor, mouthpiece, flashlight and resuscitation drugs at the bedside. 2.2 After intracranial electrode placement, closely monitor changes in vital signs, especially changes in consciousness and body temperature, and report any abnormalities to the physician in a timely manner. For postoperative patients who are not awake from anesthesia, they should be placed in a flat position with the head tilted to the side to prevent asphyxia caused by vomit aspiration. After the anesthesia is awake, elevate the head of the bed by 30 degrees to facilitate the reduction of intracranial pressure and reduce transcerebral edema. 2.3, Prevention of infection, after intracranial electrode placement, the intracranial electrode is connected with the outside world, which can easily cause intracranial infection and incision infection. To prevent complications, the preventive measures are basically summarized as follows: 2.3.1 The affected party: return to the monitoring ward after surgery, restrict visitors, avoid walking back and forth, and instruct family members to accompany the patient while wearing a mask. 2.3.2 Medical and nursing side: follow the medical advice to use antibiotics correctly and timely to prevent infection for those at risk of infection; closely monitor the temperature and changes in condition after surgery, if sudden onset of high fever or persistent high fever does not subside for more than 5 days after surgery, pay attention and report to the doctor, and give drugs to lower the temperature and other treatments. Strictly aseptic operation, closely observe whether the head dressing is dry and clean and fixed, if there is blood and fluid oozing, the doctor should be notified to change the wound dressing in time, and add sutures to the wound and drainage tube fixation if necessary. 2.4 Care of seizures during the monitoring period, in order to obtain high-quality seizure EEG, gradually stop all antiepileptic drugs after surgery, the patient is at a high-risk level of seizures, the following measures should be taken during care: 2.4.1 Go to the patient immediately when seizure occurs, adopt a safe lying position for him/her, keep the airway open, keep the head to the side when there is secretion in the mouth, wipe or suck out the secretion in time; immediately give Give oxygen immediately to prevent irreversible damage to the brain caused by prolonged hypoxia. 2.4.2 Patients should lift the covers and other coverings in time at the beginning of the seizure, and face and limbs should be completely exposed to the video range as far as possible to avoid affecting the video surveillance during the seizure. 2.4.3 Record the start time of the seizure and ask the family if it is a habitual seizure, so that timely feedback to the doctor can help diagnose and deal with it in a timely manner; the patient should follow up with any aura symptoms such as panic, fear, rising gas feeling, etc. during the waking period after the seizure. 2.4.4 Do not forcefully press the patient’s limbs and trunk during tonic clonic seizures to prevent fracture or dislocation; also pay attention to protect the patient’s head electrode wire from being grasped to avoid dislodging the head dressing and electrode wire. 2.5 Guidance for patients with low seizure frequency and long monitoring period and family members Catching seizures after intracranial electrode placement increases the pain to patients and also increases the risk of intracranial infection, in addition to the high price of EEG monitoring, which brings economic pressure to patients. If seizures do not appear for many days after surgery, patients can be arranged to perform sleep deprivation, hyperventilation, flash stimulation and other evoked means under the guidance of physicians, and assist physicians to complete monitoring requirements for different patients and take different care measures, such as patients with functional epilepsy, assist physicians to complete cortical electrical stimulation to improve functional localization and precise localization of lesions. 2.6 Drug adjustment during the monitoring period, video EEG monitoring is performed in patients after intracranial electrode placement. The first day, seizures are controlled with drugs to avoid excessive seizures and prevent brain edema formation. On the second day, the medication needs to be reduced to stop monitoring according to the relevant drug reduction plan. At this time, the patient has the possibility of seizures at any time, and to prevent affecting the EEG monitoring, the use of diazepam is prohibited, and if the seizures are frequent and reach the status epilepticus, Depakene can be given for static pushing or static drip maintenance; if the seizures are infrequent, temporary observation and oxygenation can be given; after the detection has been clearly epileptic origin, diazepam can be given appropriately to control the seizures. During treatment, the patient’s breathing should be closely observed to prevent respiratory depression. 2.7 Post-ictal care during the monitoring period, observe the patient’s pupil and state of consciousness, the presence of cyanosis, urinary and fecal incontinence, as well as the duration of post-ictal lethargy, how long it takes to be awakened, move the bilateral limbs to clarify whether they are moving well or whether they are unilaterally rigid, and give timely disposition. Some patients present post-epileptic states such as confusion and automatic behavior in the late stage of seizure before full consciousness, which should be protected. 2.8 The care of intracranial electrode leads is crucial for the localization of epileptogenic foci during video EEG monitoring after the patient has been placed with intracranial electrodes. Patients are unconscious during seizures, with twitching of the limbs or involuntary movement of the limbs. Therefore, the nurse should do a good job to protect the patient during seizure, to keep the electrode wire fixed and the EEG background running normally, to avoid the patient forcibly pulling the electrode wire and causing the electrode to shift, which may cause brain tissue damage or cause intracranial hemorrhage; use restraint belt to restrain the limbs if necessary to prevent the deep electrode from breaking during seizure; if the electrode wire falls off, the doctor should be notified in time. 2.9 Monitoring time, the monitoring time is limited to 7 days, but it is also believed that it can be up to several weeks and up to 32 days, which undoubtedly increases the risk of infection. We believe that, under the premise of guaranteeing the cleanliness of the wound dressing and the EEG not suggesting any electrode wire dislodgement, monitoring should be stopped only after capturing the patient’s usual seizures, basically being able to fix the measurement and localization, and perfecting the functional localization of electrical stimulation as needed, generally 7-10 days is appropriate. 3. As a result, all 32 patients successfully completed EEG monitoring after intracranial electrode placement, with no displacement of the placed electrodes, no intracranial infection or bleeding, and one patient with cerebrospinal fluid leakage. The patients were monitored for 7-10 days, and the usual seizures were successfully captured for many times, and the symptomatology of the seizure period and the EEG of the same period achieved the expected results, and the fixation and localization were more accurate. All were discharged cured after completion of epileptic foci resection. 4. Discussion Video EEG monitoring after intracranial electrode placement can accurately record the interictal and ictal EEG changes, precisely locate the epileptogenic foci, and provide a basis for surgical resection of epileptic foci. However, video EEG monitoring after intracranial electrode placement is an invasive test with complications and risks such as intracranial hemorrhage and infection, which makes clinical care more difficult. In order to reduce patients’ pressure and clinical complications, nursing must fully consider potential adverse factors and take active countermeasures, which not only require nurses to have rich medical nursing knowledge, but also sufficient care, patience and responsibility for patients, so as to create a good psychological state for patients; to be standardized, accurate, careful and elaborate in nursing operation as well as monitoring process, and to accurately Record various subtle changes in the patient’s nervous system to ensure that there is no displacement of electrode placement, no intracranial infection, no bleeding, no accidental injury during seizures, and provide an accurate diagnostic basis for surgery. In conclusion, targeted preparation, psychological care, safety protection during the monitoring period, careful observation of changes in the condition and strict aseptic operation can avoid complications of intracranial electrode placement and escort the surgical removal of epileptic foci.