To improve the outcome of epilepsy surgery, a comprehensive presurgical evaluation provides detailed information about possible localization of epilepsy onset and eloquent brain area.
Epilepsy surgery is an alternative treatment choice of drug resistant epilepsy. Presurgical evaluation of epilepsy surgery in Taipei Veterans General hospital started since 1987. We provided more than 100 cases per year for epilepsy presurgical evaluation. In addition, we had a total of more than 100 cases of invasive presurgical evaluation. Less than 1% had complications during presurgical evaluation. Team members are all experienced, including examiner with EEG certification examination board and member of ILAE task force of Neurophysiology.
We provide 9 beds for Video-EEG recordings. Six experiences epileptologists review the whole recordings, and conclude the possible seizure onset region. During admission, we offer patients high resolution MRI, brain PET, brain SPECT and neuropsychological tests, which are essential to provide information about epileptogenic lesion and functional deficit regions. In addition, we provided MEG, WADA test, fMRI, ictal SPECT for selective patients. We will conclude the results in seizure conference and discuss the next step with the patient and his/her family. If the patient needs invasive EEG studies, both subdural grid and stereotactic EEG could be provided.
・Non-invasive multidisciplinary evaluation, including
(1) Neuro-Electrophysiological Studies: Video-EEG, MEG,
(2) Neuroimages: high resolution MRI, fMRI,
(3) Nuclear medicine: PET, SPECT,
(4) NeuroPsychological tests.
・Seziure conferences to conclude the results of presurgical evaluation. Patient and the family can join and discuss with the epileptologists and neurosurgeon.
・Invasive electroencephalography (EEG), including subdural grid EEG and stereotactic EEG
・There is no risk or complication for non-invasive presurgical evaluation.
・For invasive presurgical evaluation, risk varies, which depends on the type of evaluations. The common complications were hemorrhage (prevalence 1.0%) and infection (prevalence 0.8%).
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