Abstract: Objective  To investigate the clinical features,  preoperative location,  postoperative efficacy and surgical complications of multifocal refractory epilepsy.Methods  The clinical data of 11 patients with multifocal refractory epilepsy from July 2013 to April 2018 in the Epilepsy Center of the First Affiliated Hospital of Soochow University were retrospectively analyzed, and all the paitents were conducted longterm VideoEEG monitoring (VEEG),  magnetic resonance imaging (MRI),  positron emission computed tomography (PETCT) and PET/MRI coregistration. Local lesions or enlarging lobectomy was implemented by the monitoring of electrocorticogram (ECoG) during operation．Postoperative scores were performed according to Engel classification and followed up.Results  Of 11 patients, encephalomalacia was found in 7 cases, ulegyria in 1 case, schizecephaly in 1 case, encephalomalacia combined with ulegyria in 2 cases. After 360 months'  followup, 7 cases(63.6%) fell into gradeⅠ, 2 cases(18.2%) grade Ⅱ, 1 case (9.1%)  grade Ⅲ, 1 case (9.1%)  grade Ⅳ.  About 63.6%  of patients had no seizures and the total effectiveness was 90.9%. Of 11 patients, infection was detected in 2 patients, hydrocephalus in 1 patient,aggravated visual field deficits in 1 patient, and right limb hemiparesis in 1 patient; no patients died during the operation. Conclusion  For multifocal refractory epilepsy,  a good prognosis can be obtained by surgical treatment based on accurate preoperative evaluation.

Key words: epilepsy； , preoperative evaluation, efficacy, complications