Surgical Reporting Program

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Existing Surgery reports

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Patient IDYear of SurgerySurgery DetailsAge at Diagnosis (years)SexRaceEthnicityEtiologyStructural EtiologyEpilepsy TypeSeizure TypesSyndromePrevious Treatment Surgery? (including neuromodulation)Referred to Level 4Primary PayerType(s) of SurgeryIntracranial EEG DetailsNeurostimulation DetailsResection, Disconnection, Ablation DetailsType of Corpus CallostomyIntent of SurgeryLocation of treatment or targetPlanned Treatment SurgeryIntraoperative ECOGComplicationsPlease Describe Other ComplicationsAdditional CommentsDate Created
Patient IDYear of SurgerySurgery DetailsAge at Diagnosis (years)SexRaceEthnicityEtiologyStructural EtiologyEpilepsy TypeSeizure TypesSyndromePrevious Treatment Surgery? (including neuromodulation)Referred to Level 4Primary PayerType(s) of SurgeryIntracranial EEG DetailsNeurostimulation DetailsResection, Disconnection, Ablation DetailsType of Corpus CallostomyIntent of SurgeryLocation of treatment or targetPlanned Treatment SurgeryIntraoperative ECOGComplicationsPlease Describe Other ComplicationsAdditional CommentsDate Created

Level 4

Pediatric Epilepsy Center

Medical Director: Deepa Sirsi

, MDMD

Co-Medical Director: Rana Said,

MD