At Ghent University Hospital patients go through an extensive work-up before the possibility of epilepsy surgery is discussed. All patients have long-term video-EEG-monitoring (usually 7 days), 3T MRI, FDG-PET and neuropsychological testing. In some patients additional investigations such as an ictal SPECT or intracarotid amobarbital test are done. Although there is long-standing expertise with EEG source localization within the clinical group, it was used infrequently due to the complexity of the source localization process and the time-investment that was required.
This has changed since we introduced Epilog PreOp and Epilog PreOp HD. Due to the ease-of-use and time-effectiveness of the Epilog service model, EEG and HD-EEG source localization is now performed for all patients that are in a preoperative work-up. With little extra time investment, we obtain additional information that can be used in the process of localizing the epileptogenic focus. Over the course of a couple of months, Epilog PreOp and Epilog PreOp HD has become an established part of the preoperative work-up.