Surgical treatment of epilepsy. Organization (localization, staff, referral procedures)

Small countries like Norway (4.2 mill. people), should centralize surgical treatment for epilepsy around a permanent team from one comprehensive epilepsy service center and the cooperating university regional hospital. The first phase of the selection procedures should be done at all regional university hospitals and at the epilepsy center. The second phase with WADA-test and ictal EEG-recordings and video-observations, and the third phase with EEG-recordings from intracranial electrodes, should be carried out by the permanent team. After implantation of electrodes at the regional hospital the intensive observation and recordings should be performed at the epilepsy center. The per-operative diagnostic procedures, with corticography, depth recordings, and localization procedures, should be carried out by the permanent team. After the operation, the patient should be referred to the epilepsy center for establishment of proper medical and psychosocial follow-up and rehabilitation. Preferably, the post-operative assessments over several years should be carried out by the permanent team.