Why the MDT format is not guaranteed
A multidisciplinary discussion is a clinical process, not a product you can order. Hospitals decide whether a case needs several specialties at one table, and that decision depends on the records available, the complexity of the epilepsy, and the treating team's own judgement. Nothing in an overseas enquiry creates an entitlement to that format.
This matters because patients often assume that sending a file to a large hospital automatically triggers a joint review. It may not. The file might be read by one neurologist, or it might sit until a specific question is answered. Before you plan travel or pay for coordination, ask the hospital or your coordination contact to state plainly whether an MDT discussion will happen, who takes part, and what the output will be.
The practical answer is to treat the MDT as a question to confirm, not a promised step. If the response is vague, ask again in writing. A clear 'no MDT, single specialist review' is more useful than an unclear 'we will see'.
The reason this distinction matters is that the two routes produce different things. A single-specialist review can answer a narrow question about medicines or seizure classification. A joint review can weigh several lines of evidence at once, but only if the evidence is in front of the people at the table. If the hospital has not committed to the joint format, you are preparing for the wrong process.
There is also a timing dimension. A joint review needs the relevant specialists to be available at the same time, and that depends on the hospital's own schedule. Ask whether the discussion happens on a fixed day, whether it can be arranged for a specific case, and how far ahead it must be requested. Do not assume that a request made during a consultation will be acted on the same week.
Ask the hospital to name the specialties it expects to involve. For drug-resistant epilepsy, that might include neurology, neurosurgery, neurophysiology or radiology, but the actual list is the hospital's decision. Knowing the list in advance tells you which records each participant will want, and it tells you whether the discussion is genuinely multidisciplinary or a single review described in broader terms.
Finally, ask what happens after the discussion. Will you receive a written summary, a verbal report, or a note added to your file? Who is responsible for explaining the conclusion to you, and in what language? A joint review that produces a conclusion nobody explains to the patient is of limited practical use.
None of this is a reason to avoid asking. It is a reason to ask precisely. A hospital that can describe its process clearly is easier to work with than one that answers only in general terms, and the written answer becomes the basis for every later decision about records, travel and cost.
The diagnosis and seizure-type question
The first thing an MDT needs to settle is whether the epilepsy diagnosis itself is correct and whether the seizure type has been classified accurately. Drug-resistant epilepsy means seizures continue despite appropriate medicines, but that label only holds if the original diagnosis and the seizure classification are sound. If the diagnosis is uncertain, the discussion should say so rather than move straight to treatment options.
For an overseas patient, this is where records matter most. The team needs the history of how seizures started, how they changed, and how they were described by witnesses. A patient's own account is valuable, but descriptions from family members or carers often add detail that changes the picture. Ask whether the hospital wants witness accounts in writing, and in what language.
The question to put to the team is direct: based on the records we send, is the diagnosis and seizure type clear enough to discuss options, or does something need to be clarified first? If the answer is that more information is needed, that is a legitimate outcome, not a rejection.
What the EEG and imaging records must show
An MDT discussion about drug-resistant epilepsy depends heavily on EEG and imaging records. The team needs to know what has already been recorded, when, and under what conditions. A single routine EEG from years ago may not be enough to support a complex discussion, but that is a clinical judgement for the treating team, not something you should assume in advance.
The useful action is to gather what exists and ask what is missing. That includes EEG reports, imaging reports, and the actual data files where available. Ask the hospital whether it wants raw EEG or imaging files, or whether reports are sufficient for an initial discussion. Do not assume that sending everything guarantees a fuller review, and do not assume that reports alone are enough.
One question that often goes unasked: will the MDT review the existing records only, or will it require new recordings or scans in China before it can reach a view? The answer changes both the timeline and what you need to prepare. Ask for that in writing before you commit to travel.
The medicines-tried question
Drug-resistant epilepsy is defined in part by what has already been tried. An MDT needs a clear list of medicines used, at what doses, for how long, and with what effect. It also needs to know about side effects and any medicines stopped for reasons other than lack of effect. Without that list, the discussion cannot judge whether the epilepsy is genuinely drug-resistant or whether the treatment history is incomplete.
This is not a request for you to change anything. It is a records question. Ask your current treating team to provide a written medicine history that the receiving hospital can read. If the history is incomplete, the MDT may not be able to answer the central question of what options remain.
The question to put to the receiving team is whether the medicine history you can provide is sufficient for the discussion, or whether specific details are missing. If they say more is needed, ask exactly what. Do not stop or alter any medicine while preparing an enquiry; that decision belongs to your treating clinician.
What the MDT can and cannot decide remotely
A records-based MDT discussion can clarify the diagnosis, review the treatment history, and identify whether further assessment is worth pursuing. It cannot examine the patient, cannot confirm final eligibility for any procedure, and cannot guarantee that a particular treatment will be offered. Those limits should be stated by the hospital, not assumed by the patient.
Epilepsy surgery can be considered for selected people whose seizures are not controlled by medicines, and assessment examines potential benefits and risks. That is the general principle. It does not mean that an MDT review will lead to surgery, or that surgery is the right path for every drug-resistant case. The discussion may conclude that more medicines should be tried, that further tests are needed, or that the case is not suitable for the options available at that hospital.
Ask the team to state, in the written output, what it has concluded and what remains uncertain. A useful MDT answer names the next step and the reason for it. An answer that only lists tests without explaining why is harder to act on.
Preparing the file and the questions to send
The quality of an MDT discussion depends on the quality of the file. Before you send anything, ask the receiving hospital what it wants and in what format. A short summary of the main question is a reasonable starting point for an initial enquiry; a complete medical archive is not needed at first contact.
When you do send records, keep the clinical question separate from the administrative one. The clinical question is what the team thinks about the diagnosis and options. The administrative question is whether an MDT will happen, who takes part, what it costs, and what the output will be. Mixing them makes it harder to get a clear answer.
A short checklist can help you track what you are waiting for. Use it only if it adds something you would otherwise forget.
The next step is to send a brief summary of the case and ask directly whether an MDT discussion is available for this type of epilepsy, what records it requires, and what the written output will contain. An initial enquiry is free and does not commit you to a proxy consultation or any paid service. The hospital decides suitability, and any clinical decision remains with the treating team.
- Ask whether an MDT will actually take place, and who will take part.
- Ask which records are needed for the discussion, and in what format.
- Ask whether new tests in China would be required before a view can be given.
- Ask what the written output will contain, and what it will not decide.
- Ask what the discussion costs, and whether it is separate from any consultation fee.
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.