Tertiary Epilepsy Centres
What happens when you're referred — and why referral does not automatically mean surgery
Most people with epilepsy are initially managed through:
a GP
paediatric service
general neurology
or a local epilepsy clinic.
For many people, this provides everything they need.
But some epilepsy becomes more complicated.
There may be:
uncertainty about the diagnosis
uncertainty about seizure type
seizures continuing despite treatment
difficult medication side effects
unusual MRI or EEG findings
possible genetic epilepsy
several different event types
cognitive or psychiatric complications
or a need for investigations and treatments that a local hospital does not provide.
This is where a tertiary epilepsy service comes in.
NICE defines a tertiary epilepsy service as a specialist service run by adult or paediatric neurologists with expertise in investigating, diagnosing and managing complex epilepsy. These services provide access to advanced investigations and treatments that may not be available through ordinary secondary-care neurology.
What does “tertiary” mean?
Healthcare is sometimes described in levels.
Primary care
Usually includes services such as:
GP practices
community care
and first-contact healthcare.
Secondary care
Includes specialist hospital care such as:
general neurology
paediatrics
and ordinary epilepsy clinics.
Tertiary care
Provides more highly specialised expertise, investigations and treatment.
In epilepsy, that can include:
epilepsy specialists or epileptologists
video EEG telemetry
specialist neuroimaging
neuropsychology
neuropsychiatry
genetics
complex medication management
ketogenic dietary therapy
vagus nerve stimulation
and epilepsy-surgery assessment.
NICE specifically includes these services in its definition of a tertiary epilepsy service.
Tertiary does not mean “more severe epilepsy”
Being referred does not automatically mean someone has the most severe form of epilepsy.
A person may need tertiary assessment simply because:
their diagnosis is unclear
their events are unusual
specialist testing is required
they need a second level of expertise
or a particular treatment is only available through specialist services.
For example, someone having unexplained episodes that could represent:
epilepsy
fainting
functional seizures
sleep events
or another neurological disorder
may be referred because diagnostic uncertainty itself is a reason for specialist review.
NICE includes uncertainty about the diagnosis, underlying cause, seizure type or epilepsy syndrome among the criteria for tertiary referral.
When should someone be referred?
NICE says people with epilepsy should be referred to a tertiary epilepsy service if any of the following apply:
the diagnosis is uncertain
the cause is uncertain
seizure type is uncertain
epilepsy syndrome is uncertain
the person has an epilepsy syndrome likely to be drug resistant
seizures are drug resistant
treatment is causing intolerable side effects
further specialist investigations are required
specialist treatments are being considered
epilepsy surgery or VNS may need considering
or the person wishes to participate in an appropriate clinical trial or research study.
For people meeting these criteria, NICE's current quality standard says they should be seen within 4 weeks of referral.
Some children need even faster referral
NICE identifies particular groups of children who should be referred to tertiary paediatric epilepsy services for an appointment within 2 weeks.
These include children who:
are under 3 years old
are under 4 and have myoclonic seizures
have a structural abnormality affecting one side of the brain
or show deterioration in behaviour, speech or learning.
These situations can require rapid investigation because some early-childhood epilepsy disorders can affect development and may benefit from prompt specialist treatment.
Drug-resistant epilepsy is an important reason for referral
Drug-resistant epilepsy has a specific meaning.
Broadly, it means that two appropriately selected, tolerated and adequately used antiseizure medication schedules have failed to achieve sustained seizure freedom.
At that point, management should broaden beyond simply trying medication after medication.
Epilepsy Action states that people who continue having seizures after two appropriate medicines should be referred to a specialist epilepsy service.
Related Information Hub page:
Drug-Resistant Epilepsy: What It Actually Means
What happens after the referral?
There is no identical pathway for everyone.
A tertiary centre first needs to understand why the person has been referred.
The referral question might be:
Are these events actually epileptic seizures?
Or:
What type of epilepsy does this person have?
Or:
Why are seizures continuing despite treatment?
Or:
Could epilepsy surgery help?
Or:
Does this person need genetic investigation?
The first specialist appointment therefore usually involves a detailed review of the existing evidence before deciding what — if anything — needs repeating.
The team may go back to the beginning
This sometimes surprises people.
Someone may arrive at a specialist centre expecting an exotic new test and instead be asked:
“Tell me exactly what happens during your seizures.”
That is not starting again unnecessarily.
The seizure history remains one of the most important pieces of diagnostic information.
Specialists may review:
the first ever events
current events
warnings or auras
consciousness
movements
sleep seizures
recovery
injuries
seizure frequency
witnesses
videos
previous diagnoses
and whether there may be more than one event type.
They may also question whether every reported event is actually the same condition.
Bring videos if you have them
Safe recordings of habitual events can be extremely valuable.
The specialist may be able to examine:
the beginning of the event
movement patterns
responsiveness
head and eye position
automatisms
breathing
duration
and recovery.
Videos do not replace EEG or clinical assessment.
But they can provide information that is difficult for a witness to describe accurately afterwards.
Previous records matter
A tertiary centre may want to review previous:
EEG reports
actual EEG recordings
MRI images
CT scans
clinic letters
hospital admissions
genetic results
medication history
neuropsychological assessments
and video telemetry.
It can be particularly important for specialists to review the original images or recordings, rather than relying entirely on a written report.
A specialist neuroradiologist, for example, may interpret an epilepsy MRI with a different question in mind from someone reviewing a scan performed for a more general neurological reason.
The medication history may be reviewed in detail
The specialist may ask:
Which medicines have been tried?
What dose was reached?
How long was each medicine used?
Did seizures improve?
Which seizure types improved?
What side effects occurred?
Why was the medicine stopped?
Were medicines ever used in combination?
Were doses regularly missed?
Were there interactions with other medicines?
Did seizures worsen after any particular treatment?
This helps determine whether epilepsy is genuinely drug resistant and whether previous treatments were appropriate for the actual seizure type.
You may not need every test repeated
Referral to a tertiary centre does not mean every investigation starts again.
If an existing:
MRI
EEG
genetic result
or neuropsychology assessment
is adequate and answers the specialist question, it may simply be reviewed.
Testing is repeated when there is a reason.
Examples might include:
the original MRI was not performed using an epilepsy protocol
the scan quality was poor
the person's seizure pattern has changed
previous EEG did not capture the habitual event
or surgery is being considered and more precise information is required.
What specialist investigations are available?
NICE's definition of tertiary epilepsy care includes access to additional specialist assessments such as:
neuropsychology
neuropsychiatry
specialised neuroimaging, including 3T MRI
and specialised neurophysiology, including video EEG telemetry.
Depending on the centre and clinical question, additional investigations can include:
prolonged video EEG
home video telemetry
advanced structural MRI
functional MRI
PET
SPECT
MEG
genetic testing
and intracranial EEG such as SEEG.
King's College Hospital, for example, describes a specialist epilepsy programme using video EEG, advanced MRI, functional MRI, PET, SPECT, neuropsychology, neuropsychiatry and stereo-EEG for selected patients.
Nobody automatically receives all of these tests.
Video EEG telemetry
Video telemetry combines prolonged EEG with simultaneous video.
It may be used to:
record someone's habitual seizure
establish whether events are epileptic
classify different event types
investigate seizures during sleep
determine seizure frequency
or localise focal seizures before possible surgery.
Specialist centres such as UCLH and King's operate dedicated prolonged video-EEG services for complex epilepsy assessment.
Related Information Hub page:
Video Telemetry: Recording Seizures in Hospital
Why might telemetry be repeated?
Someone may already have had EEGs locally.
But an ordinary routine EEG is not the same as several days of simultaneous video and EEG.
A tertiary team may need to see:
the actual habitual seizure
several examples of it
every different event type
or the electrical activity at the beginning of a seizure.
That can answer questions a short routine EEG cannot.
Specialist MRI review
Tertiary services can provide specialised neuroimaging, including 3T MRI, according to NICE.
A specialist neuroradiologist may look for abnormalities associated with epilepsy, including:
hippocampal sclerosis
focal cortical dysplasia
developmental malformations
previous injury
vascular abnormalities
or epilepsy-associated tumours.
Sometimes the important step is not another scan but having the original images reviewed again by somebody with particular epilepsy-imaging expertise.
A previous normal MRI does not always end the investigation
MRI-negative epilepsy is real.
If the seizure history and EEG strongly suggest focal epilepsy but MRI appears normal, specialists may consider:
repeat epilepsy-protocol MRI
advanced image processing
PET
SPECT
MEG
or invasive EEG.
A structurally normal MRI does not prove that seizures arise diffusely from the whole brain.
Related Information Hub page:
MRI and Epilepsy: What Doctors Are Looking For
Neuropsychology
Neuropsychological assessment examines abilities such as:
memory
language
attention
learning
processing speed
and executive function.
This may be helpful because epilepsy and its treatment can affect cognition.
It is especially important during epilepsy-surgery assessment because specialists need to understand:
existing strengths and difficulties
where important functions may be organised
and the potential cognitive consequences of treatment.
NICE specifically lists neuropsychology as one of the services available through tertiary epilepsy care.
Related Information Hub page:
Neuropsychological Testing and Epilepsy
Neuropsychiatry
Epilepsy can interact with:
mood
anxiety
behaviour
medication effects
functional neurological symptoms
and other psychiatric conditions.
A neuropsychiatrist specialises in the interface between neurological and psychiatric conditions.
Neuropsychiatry is therefore not included because clinicians assume epilepsy is psychological.
It is part of comprehensive neurological care.
NICE specifically includes neuropsychiatric assessment among tertiary epilepsy services.
Functional seizures can also require tertiary expertise
Some people referred with “uncontrolled epilepsy” are eventually found to have:
functional seizures rather than epilepsy
epilepsy plus functional seizures
or several different event types.
This can be particularly difficult when the events look dramatic or when the person already has a confirmed epilepsy diagnosis.
Specialist video EEG can sometimes establish which events are associated with epileptic brain activity.
The Walton Centre describes providing specialist video telemetry and neuropsychological support for both epilepsy and non-epileptic attacks within its comprehensive epilepsy service.
Genetic assessment
Some tertiary services also provide access to:
genetic testing
genetics multidisciplinary review
and genetic counselling.
NICE explicitly includes genetic diagnosis and counselling within tertiary epilepsy services.
Genetics may be particularly relevant in:
early-onset epilepsy
developmental and epileptic encephalopathies
recognised genetic epilepsy syndromes
learning disability
autism
unusual family patterns
or particular structural and developmental conditions.
Related Information Hub page:
Genetic Testing and Epilepsy
Specialist medication management
Tertiary care does not mean doctors stop using antiseizure medication and move immediately to surgery.
Medication remains a major part of treatment.
A specialist may:
reconsider seizure classification
change one medicine
adjust a combination
simplify polytherapy
investigate adverse effects
recommend a syndrome-specific medicine
or identify a treatment that should be avoided.
Some specialised medicines also require specialist initiation or monitoring.
NICE specifically includes access to treatments such as cannabidiol where clinically appropriate within tertiary epilepsy care.
Ketogenic dietary therapy
A medical ketogenic diet may be appropriate for selected epilepsies.
This is not simply:
“eat fewer carbohydrates.”
A therapeutic ketogenic diet is carefully formulated and monitored by a specialist team.
NICE includes ketogenic dietary therapy among treatments that may require tertiary epilepsy services.
Vagus nerve stimulation
A tertiary service can also assess whether vagus nerve stimulation — VNS might be appropriate.
VNS involves implanting a device that provides electrical stimulation through the vagus nerve.
It is usually intended to:
reduce seizure frequency
reduce seizure severity
or improve seizure control
rather than guarantee complete seizure freedom.
NICE includes access to VNS within tertiary epilepsy care.
Does tertiary referral mean epilepsy surgery?
No.
This misconception can make people anxious about referral.
A tertiary centre deals with many complex epilepsy questions, only one of which is surgery.
Someone may be referred solely for:
diagnosis
medication advice
genetic investigation
video telemetry
cognitive assessment
pregnancy-related expertise
or clarification of seizure type.
Even when the referral specifically says:
“for surgical assessment”
that does not mean an operation has already been recommended.
What does “surgical assessment” actually mean?
Surgical assessment asks:
Could treating a specific brain region provide better seizure control without causing unacceptable neurological harm?
That question can require several investigations.
The team may need to determine:
where seizures begin
whether they consistently begin in the same area
how seizures spread
whether MRI shows a matching abnormality
where memory and language functions are located
and whether the suspected seizure-generating tissue can be safely treated.
Only after that assessment can anyone decide whether surgery is actually an option.
A person can be assessed and not offered surgery
Yes.
The final conclusion may be:
surgery is appropriate
more tests are needed
invasive monitoring is needed
the seizure-onset region cannot yet be identified
seizures arise from several regions
removing the relevant tissue would carry too much risk
another treatment would be preferable
or surgery is technically possible but the person chooses not to proceed.
Assessment is therefore information gathering.
It is not a commitment.
A normal MRI does not stop surgical assessment
NICE recommends that people with drug-resistant epilepsy be considered for epilepsy-surgery assessment even when MRI has not identified a structural abnormality.
Specialist investigations may still identify a focal seizure network.
The tertiary team can then decide whether further investigation is justified.
Related Information Hub page:
Drug-Resistant Epilepsy: What It Actually Means
What is an MDT?
Complex cases are often discussed at an MDT — multidisciplinary team meeting.
This means professionals from several disciplines review the evidence together.
A specialist epilepsy-surgery MDT may include:
epileptologists or neurologists
neurosurgeons
clinical neurophysiologists
neuroradiologists
neuropsychologists
neuropsychiatrists
epilepsy specialist nurses
and other professionals as required.
Oxford University Hospitals' current epilepsy-surgery MDT, for example, includes neurologists, neurosurgeons, clinical neurophysiology, neuropsychology, neuropsychiatry and epilepsy specialist nurses.
Why use an MDT?
No single specialist sees the whole problem from exactly the same perspective.
A neuroradiologist might ask:
What does the MRI show?
A neurophysiologist might ask:
Where does the EEG suggest seizure activity begins?
A neuropsychologist might ask:
Which cognitive networks are functioning well, and what might be at risk?
A neurosurgeon might ask:
Can the suspected region be treated safely?
A neurologist or epileptologist brings those findings together with:
the seizure history
medication response
examination
and treatment options.
The MDT allows disagreements between different investigations to be examined rather than one result automatically deciding everything.
You do not necessarily sit in the MDT meeting
An MDT is usually a professional case-review meeting.
The person may not physically attend that meeting.
Instead, the team reviews:
scans
EEG recordings
test results
reports
seizure history
and treatment information.
The result should then be explained to the person so that treatment decisions can be made with them.
UCLH describes epilepsy-surgery cases being discussed after investigations are complete, followed by communication of the team's conclusions and detailed discussion of risks and benefits if surgery is appropriate.
The patient still makes the decision
An MDT can recommend a treatment.
It does not remove the person's right to decide.
If surgery is offered, the person should receive information about:
expected benefits
possible risks
cognitive consequences
alternatives
uncertainty
and what may happen without surgery.
They can then decide whether the proposed treatment is right for them.
Surgical assessment should therefore support informed decision-making, not pressure someone into an operation.
What if the tests disagree?
This is called discordance.
For example:
MRI may suggest the left temporal lobe
scalp EEG may appear bilateral
PET may point predominantly left
neuropsychology may show a different pattern.
The MDT asks why.
Possible explanations include:
rapid seizure spread
an MRI abnormality unrelated to the seizures
limitations of scalp EEG
a broader network
several seizure types
or more than one seizure-onset region.
Discordance often leads to further investigation rather than automatically cancelling treatment.
What if all the tests agree?
This is called concordance.
For example:
seizure symptoms suggest a left temporal onset
video telemetry records left temporal seizures
MRI shows left hippocampal sclerosis
PET shows compatible left temporal hypometabolism.
Multiple independent investigations pointing towards the same network provide much stronger evidence than any one test alone.
This can make treatment planning more confident.
When might SEEG be considered?
Sometimes non-invasive testing strongly suggests a limited number of possible seizure-onset areas but cannot distinguish between them precisely enough.
The team may then consider stereo-EEG — SEEG.
SEEG involves surgically placing thin electrodes into carefully selected brain regions.
It can record electrical activity much closer to where seizures are suspected to begin.
Specialist services such as King's describe SEEG as part of their presurgical investigation pathway for selected complex cases.
SEEG is not a routine test and is only considered when the potential information justifies an invasive procedure.
Tertiary care is not only about surgery
NICE's definition is much broader.
Tertiary epilepsy services may provide specialist management for particular groups including:
people with learning disabilities
pregnant women and pregnant people
people moving between children's and adult services
and older people with epilepsy.
The service is therefore designed around complex epilepsy care, not merely operations.
Pregnancy and epilepsy
Pregnancy can alter antiseizure medicine levels and requires careful balancing of:
seizure control
medicine exposure
maternal safety
and fetal safety.
Some comprehensive tertiary services operate specialist neurology-obstetric clinics for this reason.
UCLH, for example, lists dedicated obstetric-neurology care among its specialist epilepsy services.
Related Information Hub page:
Pregnancy and Epilepsy
Learning disability and complex needs
Having a learning disability should not prevent someone from accessing specialist epilepsy care.
NICE specifically says that people with:
learning disability
mental health conditions
neurodivergence
physical health conditions
communication needs
or sensory impairment
may require additional support to access tertiary services appropriately.
Possible adjustments may include:
longer appointments
easy-read information
large print
audio material
interpreters
family or carer involvement where the person wishes
or advocacy support.
Transition from children's to adult services
Epilepsy does not conveniently change departments on someone's eighteenth birthday.
Young people with complex epilepsy may require carefully coordinated transition between:
paediatric epilepsy
adult neurology
surgery programmes
genetics
psychology
and other services.
NICE includes transition care within the remit of tertiary epilepsy services.
Specialist centres such as King's also describe dedicated transitional epilepsy care for adolescents moving into adult services.
Children's epilepsy surgery services
Children who may benefit from epilepsy surgery can be referred into specialist paediatric surgical pathways.
In England, the Children's Epilepsy Surgery Service — CESS provides specialist epilepsy-surgery assessment through designated centres.
Assessment can involve several different tests before a decision is made.
Epilepsy Action explains that if surgery is not appropriate, the specialist team may also consider other treatments such as VNS or ketogenic dietary therapy.
So even a referral specifically to a surgical programme does not guarantee that surgery will be the eventual recommendation.
The local epilepsy team may still remain involved
Being referred to a tertiary centre does not necessarily mean local care disappears.
Care may be shared between:
the tertiary centre
local neurologist or paediatrician
epilepsy specialist nurse
GP
and other services.
The specialist centre may answer a particular question or establish a treatment plan and then share ongoing management with the local team.
Complex cases may continue to require tertiary follow-up.
The exact arrangement depends on the person's needs and local service structure.
Can someone be referred back again later?
Yes.
Epilepsy can change.
A person may need renewed tertiary review because:
seizures return
seizure type changes
medicines stop working
new treatments become available
MRI changes
pregnancy occurs
cognition deteriorates
or surgery becomes worth reconsidering.
A previous decision that surgery was not suitable does not automatically mean it can never be reassessed if the evidence or available treatments change.
What is worth taking to the appointment?
Useful information can include:
an up-to-date medication list
previous medicines and why they were stopped
seizure diary
seizure videos
descriptions from witnesses
details of different seizure types
known triggers
recovery symptoms
family history
previous MRI or EEG information if requested
and a written list of questions.
It can also be useful to describe what you most want treatment to improve.
For example:
complete seizure control
fewer falls
fewer tonic-clonic seizures
less medication sedation
better memory
fewer night-time seizures
or greater independence.
It is acceptable to bring someone with you
A family member, partner, carer or advocate can sometimes help by:
describing seizures
remembering questions
taking notes
or helping recall what was discussed.
NICE explicitly recognises that family, carers, interpreters or advocates may need to be involved according to the person's wishes and communication needs.
The person with epilepsy should still be included directly in conversations about their own care wherever possible.
Questions worth asking at the first tertiary appointment
Useful questions include:
Why have I been referred here?
What question are you trying to answer?
Do you agree with my current epilepsy diagnosis?
Do you agree with my seizure classification?
Do you think I have more than one event type?
Do you know what is causing my epilepsy?
Do I meet the definition of drug-resistant epilepsy?
Do my previous EEG and MRI need reviewing?
Do I need video telemetry?
Do I need another MRI?
Would genetic testing be useful?
Why would neuropsychology help?
Are you considering surgery?
If surgery is being considered, what evidence still needs to be collected?
Questions if surgery is mentioned
Useful questions include:
Where do you think my seizures begin?
How certain are you?
Do my MRI and EEG agree?
Would you need to record more seizures?
Do I need PET, SPECT or MEG?
Could I need SEEG?
Which brain functions could be at risk?
What would neuropsychological testing tell you?
What would happen if I chose not to have surgery?
Are there non-surgical alternatives?
At what point would I actually have to decide whether I wanted an operation?
Questions if surgery is not suitable
Useful questions include:
Why am I not currently considered suitable?
Were you unable to identify one seizure-onset region?
Does the seizure network involve important brain function?
Would further investigation ever be useful?
Could my case be reconsidered later?
Would VNS be suitable?
Are other neuromodulation treatments relevant?
Would ketogenic therapy help my epilepsy type?
Are there further medication combinations worth trying?
Are there research trials appropriate for me?
NICE includes access to clinical trials and research within the role of tertiary epilepsy services.
What if no new diagnosis is found?
Sometimes extensive specialist investigation still cannot identify:
a structural cause
one precise seizure-onset zone
or one explanation for every symptom.
That does not mean the referral was pointless.
The tertiary team may still be able to:
refine seizure classification
rule out inappropriate treatments
optimise medication
establish that surgery is not currently safe
identify support needs
create a clearer emergency plan
or recommend future review if new evidence becomes available.
Knowing what a test cannot establish can be clinically important too.
A tertiary centre is not a last-chance service
People are sometimes referred only after many years of uncontrolled seizures because specialist care is mistakenly viewed as something to use when everything else has failed.
Current NICE guidance takes a different approach.
Tertiary referral is appropriate whenever specialised expertise or investigation is needed — particularly when:
diagnosis is uncertain
seizures are drug resistant
treatment cannot be tolerated
specialist testing is required
or advanced treatment should be considered.
Earlier referral can prevent years being spent repeating strategies that are unlikely to answer the underlying problem.
The most important message
A tertiary epilepsy centre is not simply:
“the place you go to have brain surgery.”
It is a specialist service for complex epilepsy diagnosis and treatment.
Referral may provide access to:
expert diagnostic review
video EEG telemetry
3T MRI and specialist neuroradiology
neuropsychology
neuropsychiatry
genetic diagnosis and counselling
specialist medicines
ketogenic dietary therapy
VNS
epilepsy-surgery assessment
advanced imaging
invasive EEG in selected cases
and research opportunities.
Some people will ultimately be offered surgery.
Many will not.
And even when surgical assessment is the reason for referral, assessment comes before the decision.
The specialist team first needs to determine:
What are these seizures?
Where do they begin?
Why are they happening?
What treatments have already been tried properly?
What brain functions need protecting?
And which treatment offers the best balance of potential benefit and risk for this particular person?
That is the purpose of tertiary epilepsy care:
not automatically to move someone towards surgery, but to make sure complex epilepsy receives the level of investigation and treatment it actually requires.
Sources and further reading
NICE Quality Standard QS211 — Referral to tertiary specialist services.
Current NICE guidance defines a tertiary epilepsy service and states that people meeting referral criteria should normally be seen within four weeks, with specified groups of children requiring assessment within two weeks. It lists specialist neuroimaging, video EEG telemetry, neuropsychology, neuropsychiatry, genetics, ketogenic dietary therapy, VNS and surgical assessment among tertiary services.
NICE — Epilepsies in children, young people and adults (NG217).
Current UK guidance on epilepsy diagnosis, referral, investigation and treatment. NG217 was last updated in January 2025.
Epilepsy Action — Getting the right treatment and care for epilepsy.
UK information explaining when people should be referred to a specialist or tertiary epilepsy service, including diagnostic uncertainty, persistent seizures, specialist investigations and advanced treatments.
Epilepsy Action — Drug-resistant epilepsy.
Explains tertiary referral when appropriate epilepsy medicines have failed and referral for epilepsy-surgery assessment, including when MRI has not revealed an abnormality.
University College London Hospitals — Comprehensive epilepsy care.
Describes a multidisciplinary specialist epilepsy service including epileptologists, neurosurgery, neurophysiology, neuropsychology, neuropsychiatry, epilepsy nursing, genetics and inpatient video-EEG telemetry.
King's College Hospital — Epilepsy service.
Current NHS information describing advanced presurgical investigations including video EEG, advanced MRI, functional MRI, PET, SPECT, neuropsychology, neuropsychiatry and stereo-EEG.
Oxford University Hospitals — Epilepsy Surgery Multidisciplinary Team.
Shows the multidisciplinary structure of a specialist epilepsy-surgery service, including neurology, neurosurgery, neurophysiology, neuropsychology, neuropsychiatry and specialist nursing.
Information reviewed: September 2026.
This page provides general educational information. Referral pathways and the investigations available vary between regions and between adult and paediatric services.
