Epileptiform discharges are the result of increased excitability of neurons or groups of neurons as manifested on the EEG by abnormal synchronized activity of local neurons, followed by excitatory loop gain. The combination of high excitability, excessive synchronization activity, neuronal inhibition, and nonspecific triggers transforms intermittent-like discharges on the EEG into clinical seizures via specific conduction pathways. Antiepileptic drugs are used to control seizures by inhibiting the excessive synchronization of neurons that constitute the seizure or by sustaining the release, reducing excitatory transmitters, and decreasing excitatory transmission, so either antiepileptic drug can control the symptoms of seizures but cannot completely change the interictal EEG, and in some patients EEG abnormalities can persist for a long time. Therefore, whether the EEG is normal or not cannot be the only criterion for stopping the medication, but it has a reference value. As for the standard of epilepsy cure and drug discontinuation, it is believed that there is no gold standard for absolute drug discontinuation. After regular antiepileptic drug treatment, 70% of epileptic patients can control their seizures and can be considered cured if they are seizure-free for more than 3 years. It is usually considered clinically appropriate to taper to discontinuation after 3 to 5 years of seizure freedom. Some patients may still experience a recurrence of seizures during the taper or several years after discontinuation, especially in patients with secondary brain lesions or persistent EEG abnormalities, and the recurrence rate is higher than in patients with normal brain MRI and EEG examinations. About 20-30% of patients with epilepsy will be difficult to control with any medication, clinically known as drug-refractory epilepsy. These patients need to be considered for surgical treatment. I am often asked, “How do you locate the epileptic focus?” I tell them graphically: locating the epileptic focus is like catching the “bad guy”. The diagnosis and treatment of any disease is a step-by-step process, like collecting “evidence” of a bad guy’s crime, you can’t just look like a bad guy and arrest him, you have to investigate his history, performance, preferably with video or catch him in the act, the bad thing is done by you! As for what causes further analysis. Then medical history, specific seizure performance, examination data, imaging films, EEG, especially video EEG during the seizure period, liver and kidney function, blood concentration tests, etc. are all objective information, which have their own reference value for locating the epileptic focus. Special cases also require special equipment such as intracranial electrodes, magnetoencephalography, etc. When it really comes to catching the bad guys, we also need to be fully prepared to protect the masses and important functional facilities. Corresponding to epilepsy surgery is the microsurgery to locate the function and blood supply around the epileptic foci. The smallest damage for the biggest gain!