mortality rate of patients with epilepsy is 2–3 times that of the general population [1], experts argue that once the diagnosis of epilepsy is established, treatment needs to be started. International organizations have three different views on the diagnosis of epilepsy. In 1981, the International League against Epilepsy and the World Health Organization suggested that the presence of epilepsy should not be determined until a second seizure. However, in 2005, the International League against Epilepsy pro­posed that the rst noninduced seizure is diagnosable as epilepsy; for the diagnosis of epilepsy in this case, several important conditions have been established, such as the need to determine whether the epilepsy patient’s brain has a susceptibility to recurrent seizures. The determination of this susceptibility includes a family history of epilepsy, a clear epileptoid discharge on the electroencephalogram (EEG), and the existence of factors that have been proven to cause recurrent seizures, such as delayed epilepsy after a head injury, epilepsy left over from encephalitis, and late­onset epilepsy caused by cerebrovascular disease [2]. The 2014 criteria required that the probability of recurrence within 10years be greater than 60% [3]. However, a large number of studies have suggested that starting treatment after the rst or sec­ond episode has no effect on the outcome of the patient’s treatment [4]. Based on these studies, we argue that (1) when there are ILAE seizure susceptibility precon­ditions, treatment can be started after the rst seizure, and (2) if the collected data are not sufcient to support the above preconditions, waiting for the patient to have a second seizure may be more benecial to the patient. Existing antiepileptic drugs are mostly for the control of seizures and have no antiepileptic effects; therefore, for patients who only have one attack for more than six months to several years, the pros and cons of starting treatment or no treatment should be explained clearly to the patients and their relatives, and the patients or their families should decide whether to use drugs. If patients or their families seek the advice of doctors, experts believe that drug treatment is safer [4, 5].