Objective      To analyze the relationship between the frequencies of high frequency oscillations (HFOs) and spike-sharp waves in interictal and preictal stages of refractory symptomatic epilepsy

and the spatial distribution characteristics of HFOs around the lesions

in order to discuss the value of HFOs in localization of the  epileptogenic zone.       Methods      The video electroencephalogram (V-EEG) of 131 seizures in 47 patients with refractory symptomatic epilepsy admitted in our hospital from September 2012 to September 2013 was retrospectively analyzed. According to the frequency of interictal spike-sharp waves

the patients was divided into 3 groups: group A (with high frequency of spike-spine waves)

group B (medium frequency of spike-spine waves)

and group C (low frequency of spike-spine waves)

and the frequencies of HFOs (Gama

Ripples) in the 3 group were compared. According to the relationship with the lesion location

the spike-sharp wave location was divided into group D (lesion zone group) and group E (non-lesion zone group)

and the frequencies of HFOs in the 2 groups were compared to analyze the sensitivity and specificity of HFOs and spike-sharp waves in the lesion zone group. The frequencies of preictal HFOs and spike-spine waves in the seizure onset zone (SOZ) were further explored.       Results      Among groups A

B and C

the higher the frequency of the spike-sharp waves was

the higher the frequency of the HFOs was (P0.05). The frequency of HFOs in group D was higher than that of group E (P0.05). The spike-sharp waves were more sensitive than the HFOs in the lesion zone

but the specificity was lower (P0.05). The incidence of preictal HFOs (47.4%

37/78) in the SOZ was higher than that of the spike-sharp waves (29.5%

23/78) (P0.05).       Conclusion      The combination of the spike-sharp waves and HFOs can improve the localization accuracy of the epileptogenic zone.