Visit preparation
Epilepsy keeps recurring. What does a surgical evaluation check?
If seizures continue despite medication, discuss assessment at an epilepsy centre. The team checks the diagnosis, where seizures begin and whether treatment could control them without unacceptable risks to speech or movement.
The evaluation starts by checking the diagnosis
If seizures continue after appropriate antiseizure treatment under medical supervision, discuss referral to an epilepsy centre. International League Against Epilepsy experts define drug resistance as failure to achieve lasting seizure freedom after adequate trials of two tolerated, appropriately chosen regimens. A doctor reviews the records to determine whether this applies.[1]
The team may first check whether the episodes are epileptic and identify the seizure type. Clarifying the type can help guide treatment even if surgery is never performed.[1]
What EEG and imaging tell the team
Long-term video EEG records movements and responses alongside the brain's electrical activity during an episode. MRI shows brain structure. If the findings point to the same area, they can help locate the seizure onset. An MRI with no visible lesion does not end the evaluation.[1]
The team also assesses what functions that area serves. When routine tests cannot locate the onset adequately, some patients need stereoelectroencephalography (SEEG). It records signals through electrodes placed inside the skull. This is an invasive test and does not commit the patient to resection.[1,2]
Why test speech and movement?
In a 2024 case reported by Xiong'an Xuanwu Hospital, drug-resistant seizures involved multiple lobes. The team used SEEG to discuss the planned extent of resection, then used cortical EEG during surgery and tested reading and limb movements while the patient was awake. Locating seizure onset and deciding what can safely be removed are separate judgments.[2]
The report describes clear speech and good limb movement after surgery. It does not give long-term seizure outcomes or a complete account of adverse events. If the onset cannot be located or the area cannot be safely removed, doctors may discuss options such as neuromodulation, usually to reduce seizure frequency or severity.[1,2]
Bring a record of the episodes
Bring previous EEG reports, any original scans you can obtain, treatment history and the timing of typical episodes. Share any videos the family already recorded safely. Ask which tests point to the same area and which additional test could change the decision.
Before travelling to China, you can consider a specialist video consultation. SinoCareHub can help organise your records and questions. The doctor determines seizure location and treatment.
Need help?
Tell us about your situation and needs. Incomplete records are welcome.