Abstract

For many years, section of epilepsy (in the neurological Institute) at Taipei Veterans General Hospital is one of the leading epilepsy referral centers in Taiwan. We have most attending physicians specialized in clinical epileptology providing outpatient and admission service for the diagnosis and treatment of seizure disorder and epilepsy.

The epilepsy surgical program at VGH-TPE is establishes in 1987. The main goal is to offer detailed presurgical evaluation for patients with refractory epilepsy and to seek available alternative treatments including surgical treatment. Presurgical evaluation consists of video-EEG monitoring in the epilepsy monitoring unit, brain magnetic resonance imaging, single photon emission computed tomography, positron emission tomography, and neuropsychological assessment including intracarotid amobarbital test or Wada test. Intracranial recording, foramen ovale electrodes and subdural electrodes are implanted in patients who have ambiguous temporal lobe onset or non-temporal focal epilepsy such as frontal epilepsy.

At present, a total of more than 500 patients have undergone surgical treatment for epilepsy, most of them received standard anterior temporal lobectomy, and ninety percent of patients achieve seizure-free or almost seizure-free outcomes postoperatively. For patients with non-temporal focal epilepsy after intracranial EEG evaluation, seizure-free rate reaches 50% or better.

The efficacy and tolerability of novel or so-called newly developed antiepileptic drugs in our patients with intractable epilepsy, and clinical researches including ictal manifestations during antiepileptic drug withdrawal, magneto-encephalography, and posterior cerebral artery Wada test of patients with temporal lobe epilepsy have been published in internationally renowned medical journals like Epilepsia and Seizure.

This surgical program is basically multi-disciplinary and has kindly participation of medical staffs and paramedical personnel from Section of Epilepsy, Department of Neurosurgery (Section of Pediatric surgery), Department of Nuclear Medicine, Section of Neuroradiology (Department of Radiology), Department of Psychiatry, Department of Pathology, Department of Rehabilitation, Department of Pharmacy, and the Nursing Department etc. We would like to thank a fully support from our directors. And, finally, we hope the establishment of an internationally well-known epilepsy institute at VGH-TPE is not merely a dream in the near future.