Why a generic document list fails this question
A drug-resistant epilepsy enquiry is a records-interpretation question, not a paperwork question. The receiving team needs to see the pattern of seizures over time, the electrical activity recorded on EEG, and what has already been tried. A folder containing every discharge summary, blood test and prescription receipt does not answer those three things. It can even slow the review, because the relevant signal is buried.
The practical test is whether a neurologist or epileptologist who has never met the patient could, from your file alone, describe the seizure types, their frequency trend, the EEG findings, the medicines used and the response to each. If not, the file is incomplete for this purpose even if it is thick.
This matters because epilepsy surgery can be considered for selected people whose seizures are not controlled by medicines, and assessment examines potential benefits and risks. That assessment depends on records that show whether the patient is in the group worth evaluating further. It does not depend on how many pages you send.
The seizure record: what a diary must actually show
A seizure diary is only useful if it is dated and consistent. For each event, the team needs the date, the time if known, what the patient was doing, what the seizure looked like to an observer, how long it lasted, and how the patient was afterwards. A line reading 'seizure, bad' tells the clinician almost nothing. A line reading '14 March, 06:40, waking, right arm stiff then whole-body shaking, about two minutes, confused for 20 minutes, no rescue medicine' is a clinical document.
Observers matter. Many seizure descriptions come from a family member or colleague, and that is normal. Note who provided the description, because a first-hand account carries different weight from the patient's recollection of a period they were not aware during.
The trend is as important as any single event. A diary that shows monthly counts over the past year, with any clusters, emergency department visits or injuries marked, lets the team see whether the pattern is stable, worsening or changing in character. A change in seizure type is a clinical question for the treating team, not something to interpret yourself.
If the patient keeps no diary, start one now and send what exists. Do not delay local clinical care while assembling records for an overseas enquiry.
EEG records: reports are not a substitute for traces
EEG is where most overseas enquiries lose the most value. A one-line report saying 'abnormal EEG' cannot be re-read. The treating team usually wants the original traces or digital files, the montage and settings, the date, whether the recording was routine, sleep-deprived or prolonged, and the formal report with the electrophysiologist's description.
Send every EEG you have, not only the most recent. A sequence of recordings over months or years shows evolution that a single study cannot. If earlier recordings were done at a different hospital, request the files rather than accepting a summary letter.
Label each file clearly: date, hospital, recording type, and whether the patient was on medication at the time. If a recording was done during a medicine change, say so, because that context changes how the result is read.
Do not attempt to interpret the traces yourself, and do not ask a coordinator to do so. Interpretation belongs to the clinical team. Your job is to make the raw material available in a form they can open.
Medicines already tried: the list that decides the next question
Drug-resistant epilepsy is defined by the failure of adequate trials of medicines, so the medication history is central, not background. For each anti-seizure medicine, the team needs the name, the dose reached, how long it was taken, whether it was taken consistently, and what happened: no change, partial reduction, side effects, or withdrawal because of intolerance.
A common gap is a list of drug names with no doses. 'Tried levetiracetam' does not show whether an adequate trial occurred. Another gap is a medicine that was stopped for side effects but recorded only as 'discontinued', leaving the team unable to tell whether the drug failed for efficacy or tolerability. Those are different clinical situations.
Include current medicines, doses and the prescribing clinician's plan, plus any rescue medication protocol. Include relevant blood test results that were used to monitor the medicines, and any allergy or serious adverse reaction.
Do not change, stop or restart any medicine to prepare for an enquiry. Medication decisions belong to the treating clinician who knows the patient. If you are unsure what was tried, ask the original prescriber for the prescription record rather than reconstructing it from memory.
Imaging and the multidisciplinary evaluation question
If MRI has been done, send the original images and the radiology report, not only the report. The date and the scanner protocol matter, and a radiologist reviewing the images may need to compare them with the EEG findings. If no MRI has been done, that is a question for the treating team, not a gap for you to fill by booking a scan yourself.
A multidisciplinary evaluation is the point at which seizure history, EEG, imaging and neuropsychological information are considered together. It is a review process, not a single appointment, and it may conclude that surgery is not suitable, that more investigation is needed, or that a different treatment route should be discussed. An enquiry or a records review does not establish that surgery will be offered.
For an overseas patient, the practical question is whether the records are complete enough for that discussion to begin. If key items are missing, the team may ask for them before forming a view. That is a normal part of the process, not a rejection.
How to send the file and what to confirm with the provider
Start with a short summary rather than a complete archive. The initial enquiry is free and asks for the main question, the working diagnosis, current medicines and the records you already hold. Do not send passport numbers, payment details or a full medical file at this stage.
Once the team has reviewed the summary, they can tell you which specific items are needed and in what format. Ask them directly: which EEG files do you need, in what format, and how should imaging be transferred? Ask whether the review will be records-based or require the patient to travel, and what the written scope of any coordination service includes.
For anything involving fees, ask for a written quote that states what is included, what is excluded and what remains undecided. Hospital consultation, test and treatment charges are paid to the hospital or relevant provider, and coordination fees are separate. Do not rely on a verbal estimate.
Keep one master index of your records with dates and sources, and send a copy of that index with every submission. It saves the clinical team time and reduces the chance that a key EEG or medication record is overlooked.
If seizures are worsening, prolonged or causing injury, seek local urgent care first. An overseas enquiry can proceed in parallel, but it should not delay assessment where the patient is.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.