1. Which patients are suitable for surgical treatment? Surgery is indicated for drug-refractory (intractable) epilepsy, which generally refers to refractory secondary epilepsy, but not all patients with poor drug therapy can be operated on and require a detailed preoperative localization evaluation before surgery can be performed. A widely accepted indication is to consider surgical treatment after regular treatment with 2-3 antiepileptic drugs for a sufficient period of time and seizures remain uncontrolled. Surgery is not the preferred treatment for epilepsy, and there are risks associated with surgery itself. For patients who have not previously been formally diagnosed and treated with medication, the decision should be made after a period of observation with regular medication. 2. What tests are included in the pre-surgical localization assessment of epilepsy? The preoperative localization assessment is the key to the success of the surgery. The preoperative evaluation must be adequate, detailed and comprehensive. At present, there are various tests used for preoperative evaluation and localization, which can be divided into non-invasive tests and invasive tests. Non-invasive: including scalp EEG (seizure and interval), CT, MRI, PET, functional MRI, neuropsychological assessment, and magnetoencephalography. Invasive: including pterygoid electrodes, intracranial electrode placement, intracranial electrode EEG, Wada test, cortical electrical stimulation (brain function localization), etc. 3. What are the pre-surgical evaluation considerations for epilepsy surgery? It is neither feasible nor necessary to perform all tests in every patient. The relevant tests should be selected on a case-by-case basis with the criterion of obtaining satisfactory localization information. It is not possible to draw conclusions from one examination tool; the localization diagnosis is the result of a combination of examinations from multiple disciplinary areas. The specific combination of selected examinations should include at least the localization analysis of EEG and seizure symptoms during the seizure and interictal periods, head magnetic resonance (MRI), neuropsychological examination, etc. (1) Interictal EEG refers to the EEG recorded during the non-ictal period of the patient. The main observation items are the background brain functional activity and the epileptiform discharges during the non-ictal period, which have important localization value, but another comprehensive localization analysis should be performed in combination with the EEG and video symptom performance during the seizure period. (2) Seizure EEG, including the electrical activity of the brain during the seizure period and the recording of clinical events of the patient during the seizure period, should generally be monitored to record at least 3 or more seizure manifestations consistent with the usual natural seizures. The site of brain discharges during the seizure period and the manifestation of the patient during the seizure play the most important role in the localization of the epileptic focus. If the results of various noninvasive tests are inconsistent, the epileptic foci are deep in the site, the head MRI lesions are more extensive, multiple lesions, and the lesions involve important functional brain areas, etc., intracranial electrodes need to be buried for more precise epilepsy localization. 4. What should I pay attention to during epilepsy localization and diagnosis with medication? During the pre-surgical localization evaluation of epilepsy patients, patients should not stop the medication when EEG monitoring is performed, because the site and mode of epileptic discharges may change after the medication is stopped, which may even affect the localization of the epileptic foci and affect the surgical effect. In addition, the reduction of medication may aggravate the seizures and even cause persistent status epilepticus, which may cause unnecessary harm to the patient. If some patients do need to reduce or stop medication to induce seizures, this must be done under the guidance of a specialist. The aim is to control the extensive neurological discharges in the brain caused by long-term chronic epilepsy and its risk of inducing seizures, and also to control the potential epileptogenic areas in the brain and prevent the development of new epileptic foci in areas with seizure potential, so as to achieve a complete cure with no residual effects. For patients who do not have seizures after surgery, it is generally necessary to insist on taking antiepileptic drugs for at least 2 years, and then gradually reduce and stop the drugs when there are no epileptic-like discharges on the EEG.