Epilepsy is a common brain disorder caused by abnormal neuronal discharges in the brain, resulting in seizures, transient, repetitive and stereotyped movements of the body, confusion, mental and behavioral abnormalities. The prevalence of epilepsy is around 5 percent. The prevalence of epilepsy ranges from 5‰ to 11.2‰, and there are about 9 million people with epilepsy in China. Epilepsy is a serious threat to the physical and mental health of human beings, and long-term seizures can not only damage intelligence or personality, but also impose a heavy burden on families and society. A. Diagnosis of epilepsy The localization of epileptogenic foci and cortical functional areas is a prerequisite for the effectiveness and safety of surgical treatment of refractory epilepsy. The localization of epileptogenic foci currently requires a combination of methods for localization. 1. Clinical symptomatology: the specific manifestation, duration and frequency of seizures, as well as the presence or absence of aura before the seizure and the performance when consciousness is not lost, can often provide direct information about the epileptogenic focus. For example, in medial temporal lobe epilepsy, seizures often manifest as hazy consciousness, lip smacking, chewing, swallowing, and hand groping, which can progress to generalized convulsions in severe cases. Some patients also have premonitions, such as rising stomach gas, fear, and déjà vu. The doctor can determine the possible site of origin of the seizure based on these premonitions and then conduct targeted examinations. Therefore, it is extremely important for patients and their families to give a truthful and detailed account of their medical history. EEG: EEG is one of the most important, meaningful and economically convenient auxiliary tests for epilepsy, and is also an essential tool for localization and diagnosis. The EEG has localization significance due to the large number of abnormal excitatory impulses transmitted to form a synchronized rhythm, forming high amplitude pathological waves, which are restricted or asymmetric, especially in partial seizures where the patient has seizure aura or no loss of consciousness. Due to the short duration of conventional EEG examination, it often does not fully and correctly reflect the patient’s discharge. In contrast, long-range dynamic EEG examination can be followed by replay of electrical signals and also simultaneous video monitoring, which can retrospectively analyze the performance during seizures and simultaneous EEG discharges simultaneously and has important reference value in the localization of epileptogenic foci. The current intensity recorded by scalp EEG is extremely weak and easily disturbed, while the current intensity recorded by intracranial electrode EEG (cortical EEG and deep electrode EEG) can reach more than ten times that of the scalp, so the abnormal discharges can be caught earlier and more sensitively, greatly improving the accuracy of localization. 3.Magnetic resonance: magnetic resonance (MRI) can clearly display the structure of brain tissue. For secondary epilepsy caused by developmental malformations, tumors, vascular malformations, softening foci, cysts and other structural changes, MRI can perform good localization. The world’s most advanced intraoperative MRI (3.0T), combined with intracranial electrode cortical stimulation mapping localization technology, can precisely determine the location of cortical functional areas before surgery, and monitor the scope and extent of resected or disconnected brain tissues and fibers in real time during surgery to avoid intraoperative damage to important functional areas, which is expected to maximize the accuracy and safety of surgery and greatly improve the The efficacy of epilepsy surgery is greatly improved. 4. Positron emission tomography (PET): PET is not only a structural but also a functional image. The glucose metabolism of epileptic foci is different from normal brain tissue. The increase of glucose uptake during seizures and a short time after seizures is 82%-130%, which is a high metabolic change, while the decrease of metabolism during interictal period is about 14%-58%, which is a low metabolic performance. When PET shows a localized glucose metabolism drop area on one side, it often has interictal spike or sharp wave issuance on EEG, while the original glucose decrease glucose metabolism increases in the EEG spike issuance area during seizure, there is high consistency, but PET shows a much wider lesion, both provide characterization and localization from different angles, both are very accurate basis for determining the epileptogenic focus. Localization of the epileptogenic focus and cortical functional areas is a prerequisite for the effectiveness and safety of surgical treatment of refractory epilepsy. Due to recent leaps in neuroimaging and electrophysiology, the ability to diagnose epileptogenic foci has been effectively improved. However, there is no single examination method that can provide decisive localization information. It is necessary to determine the location and extent of the epileptogenic foci after a comprehensive analysis by multiple examinations and in combination with clinical aspects, and also to evaluate whether the damage in the region causes unacceptable neurological dysfunction. In conclusion, the localization of epileptic foci currently requires a combination of methods: clinical symptomatology, structural imaging (e.g., MRI, etc.), electrophysiological examinations (various types of EEG and magnetoencephalography), and nuclear medicine examinations (e.g., PET, etc.). Among them, EEG and MRI are the most basic auxiliary examinations for epilepsy. The treatment of epilepsy Once epilepsy is diagnosed, most of them should be treated with regular antiepileptic drugs. There are many types of antiepileptic drugs, and the most important basis for drug selection is the type of seizure and the type of epileptic syndrome. 70%-80% of patients can be effectively controlled by regular drug therapy (including those who do not have seizures and those who still have a few seizures). The surgical evaluation of drug-refractory epilepsy should be considered. Surgical treatment of epilepsy is mainly indicated for drug-refractory epilepsy, accounting for about 20%-30% of patients. In the past, surgical treatment has been less experienced and riskier, and generally refers specifically to more than 4 seizures per month. However, this is not absolute, and some types of epilepsy with clear foci that have few seizures but are not expected to be fully controlled by drugs in the future and where surgery is expected to be effective should also be operated on as early as possible. For example, medial temporal lobe epilepsy is the most common type of epilepsy in adults and one of the drug-refractory epilepsies for which surgical treatment is effective. Surgical treatment should also be considered once “first-line” antiepileptic drugs have failed because of the progressive exacerbation of these lesions.