According to statistics, the prevalence of epilepsy in China is about 5%. ～The prevalence of epilepsy in China is about 5 to 7 percent. There are 6 million epilepsy patients in China who need long-term medication to control their condition. Among them, drugs are effective for 70 to 80 percent of patients, while 20 to 30 percent of patients taking drugs are ineffective and belong to refractory epilepsy. Experts point out that 50% of patients with refractory epilepsy can undergo surgical intervention, especially adolescent patients who meet the surgical indications can avoid liver and intellectual developmental damage caused by long-term drug use. If a patient with epilepsy has been taking regular systemic medication for more than two years, but the results are not good, with about four seizures per month, or if the antiepileptic drugs cause liver and intellectual damage and seriously affect life and work, he or she can be classified as refractory. The reason for drug resistance is not only related to irregular medication, but also related to problems with the neurons themselves that form the epileptic focus. Fifty percent of patients with refractory epilepsy usually meet the indications for surgery. He said an average of 25,000 to 30,000 epilepsy patients need surgical intervention each year in China, but the annual volume of surgeries nationwide is only a few thousand cases, accounting for less than one-third. “Many people have fear when they mention open-heart surgery, thinking that there will be sequelae once the surgery is performed.” Epilepsy is divided into two categories: primary and secondary. The former does not show structural changes in the brain on imaging, but the patient has obvious symptoms and an abnormal EEG. The latter are mostly structural changes, and surgical treatment is preferred. Secondary causes of epilepsy include brain tumor compression, brain softening foci formed after traumatic brain injury, arteriovenous malformations, and cavernous hemangiomas. Epilepsy caused by arteriovenous malformations is more common in adolescents. There are many surgical procedures for the treatment of epilepsy, which are divided into three main types, namely epileptogenic foci resection, functional surgery and neurostimulation. Epileptogenic foci resection is the most common and is by far the most effective procedure. The latter two procedures are effective in a small number of patients with specific types of epilepsy, but have a relatively high recurrence rate. Focal epileptic resection is the most effective procedure. Focal epileptic resection is performed when the condition is confined to a particular cortex, lobe, or hemisphere, and the resection does not usually result in loss of speech, movement, or other functions. This procedure includes lobectomy and cortical resection. Neurostimulation involves the implantation of special electrodes in the body to stimulate the cerebellum and vagus nerve, which has the effect of blocking seizure wave transmission signals. This method is similar to the treatment for Parkinson’s disease and requires the implantation of batteries and electrodes in the body, which is more expensive, usually costing $100,000. Patients who have a diffuse distribution of epileptic waves in both hemispheres by EEG are inoperable; patients with low intelligence, especially those with an IQ below sixty, have poorer postoperative recovery; and patients who are weak or have other organ lesions should wait until they are well before considering undergoing surgery. There are certain risks associated with the surgery There are also certain risks associated with the surgery. Some patients may develop intracranial hemorrhage and infection, and a small number of patients may exhibit neurological deficits such as altered epilepsy type, memory loss, aphasia, and hemiparesis. Nationally, complications are reported to occur in less than 10% and surgical mortality in less than 4%. The preoperative evaluation of this type of surgery is very important and requires a high level of examination tools and physician skills, and patients should consider all of these conditions before choosing a hospital. After surgery, patients usually have to take medication for two years to consolidate the effect. If there are no further seizures during this period, or if there are only one or two seizures, a gradual reduction in medication can be considered until the medication is completely discontinued. Which patients are suitable for surgery Patients with primary epilepsy who have been treated with regular systemic medication for more than two years but have poor results, have about four seizures per month, or have liver or intellectual damage caused by antiepileptic drugs, which seriously affects life and work, can have surgery if the seizure waves are confined to the lobes or one hemisphere of the brain after EEG examination. Surgery is usually preferred for patients with secondary epilepsy. After craniotomy for encephalopathy, some patients also develop cerebral softening foci, which are medically induced epilepsy. Surgical removal of the epileptogenic foci can provide relief.