Program

Executive Summary：
Dr. Chung-Chin Kuo is a neurologist who is interested in electrophysiology and thus relevant diseases such as epilepsy and movement disorders. He received his MD and PhD degrees from National Taiwan University and Harvard University, respectively. As a professor in the Departments of Physiology and Neurology in National Taiwan University School of Medicine, he has set a lab studying from single channel in isolated cell patches to in vivo recordings in freely moving animals. He has endeavored to decipher more of the biophysical and network bases of brain oscillations, and thus more effective pharmacological as well as electrophysiological interventions when the oscillations go wrong.

Lecture Abstract：
Electoencephalograms (EEG) are local field potentials (LFP) generated in the cerebral cortex and recorded on the scalp. Like all LFP, it is based on the time-dependent changes of net electric current flow (and the relative constant resistance) between the two recording electrodes. These net currents are chiefly contributed by densely repetitive activities of cortical pyramidal neurons, because of the unique temporal synchronization and spatial orientation. The cortical pyramidal neurons, however, intimately interact with local interneurons and thalamic reticular as well as relay neurons. The oscillating waves in EEG therefore could be simplistically viewed as repetitive synchronous burst-suppression activities in groups of pyramidal neurons, with similar but phase-shifted discharges in local interneurons and corresponding thalamic reticular and relay nuclei. The mutual entrainments (positive and negative interferences) among the oscillating elements based on relevant physical and biological rules then determine the amplitude and frequency of the waves on EEG at any particular moment. Because EEG is the only easily accessible and noninvasive tool for a peep of the brain activities, one shall try to describe EEG recordings with not only phenomenological terms but also in-depth mechanistic deliberations. We may then have more insight into the cellular and network activities of the prosencephalon, and in turn, more effective and/or novel clinical management of the electrophysiological pathology.

Executive Summary：
Dr. Shang-Yeong Kwan is the consultant of Children’s Hospital of China Medical University, Taiwan, and also a part-time visiting staff member at the Section of Epilepsy, Neurological Institute at Taipei Veterans General Hospital, Taiwan, where he retired in 2023. He was the President of Taiwan Epilepsy Society (TES) from 2013–2015, and the President of Children’s Epilepsy Association of Taiwan (CEAT) from 2017-2019. Also the chairman of ILAE-CAOA-ASEPA (2019-2023). Before retirement, he also served as Clinical Professor of Neurology at the National Defense Medical College in Taiwan for decades.

Dr Kwan received his medical education from Kaohsiung Medical University, Kaohsiung, Taiwan, and graduated in 1983. After completing his national military service in the Republic of China Navy, he enrolled as a Resident of Neurology at Taipei Veterans General Hospital, Taipei, Taiwan in 1985 where he progressed to Clinical Fellow in 1991. Dr Kwan then travelled as a Research Fellow to the Toronto Sick Children’s Hospital at Toronto University, Toronto, Canada, and subsequently became board-certified as an EEG specialist in Canada, in 1992. Dr Kwan also holds a Master of Law, which he obtained in 2006 from Soochow University in Taipei, Taiwan.

Dr Kwan is actively involved with professional bodies dedicated to epilepsy in Taiwan: after his back to Taiwan in 1993, he had served several terms as the secretary general, board of director and supervisor of TES and CEAT for decades. With his dedication to epilepsy education, he was awarded the Asian and Ocean Outstanding Achievements Epilepsy Award by ILAE- CAOA in 2018. Although he has retired now, he still actively teaching the EEG and epilepsy in many medical centres of Taiwan and joining the teaching courses of ASEPA around all Asian countries.

Lecture Abstract：
Electroencephalography (EEG) remains a cornerstone in the diagnosis and management of seizure disorders. EEG measures electrical activity of the brain via scalp electrodes, a simple and non-invasive method, to detect abnormalities in cortical function. In patients with suspected epilepsy, EEG is essential for confirming the diagnosis, classifying the seizure type/epilepsy syndrome, and guiding treatment decisions.

Interictal EEG may reveal epileptiform discharges such as spikes, sharp waves, or spike-and-wave complexes, which strongly suggest an underlying seizure disorder even in the absence of clinical seizures. In focal epilepsy, these findings are often localized, while generalized discharges indicate generalized epilepsy syndromes. In addition to the epileptiform discharges, focal continuous slowing in EEG might suggest focal structural lesions, while diffuse slowing in the background activity is frequently seen in the developmental and epileptic encephalopathy (DEE). Epilepsy of benign nature usually possess normal background activity. However, a normal EEG does not exclude epilepsy; repeat recordings or prolonged monitoring may be needed, particularly with video-EEG.

EEG also plays a critical role in evaluating non-epileptic events, differentiating psychogenic non-epileptic seizures (PNES) from true epileptic seizures. In refractory cases, continuous EEG monitoring in epilepsy monitoring units (EMUs) helps to capture events, localize seizure onset zones, and assess surgical candidacy.

Additionally, EEG findings often correlate with prognosis; for instance, frequent interictal discharges may indicate poor seizure control. Usually, the success of seizure freedom depends largely on the disappearance of epileptiform discharges in the EEGs before weaning antiseizure medications.

In summary, EEG is an indispensable tool in the assessment of seizure disorders. While limitations exist, such as sensitivity, difficulty in interpretattion and variability between individuals, its ability to provide real-time, functional insights into brain activity makes it invaluable in both diagnosis and long-term.

Executive Summary：
Trained at St. Bartholomew's Medical School in London, Fellowship in neurophysiology at Duke University Medical Center and director of EEG/EP at Johns Hopkins Bayview Medical Center since 1987 with interests in nonconvulsive status, coma and encephalopathy.

Lecture Abstract：
The EEG reflects different encephalopathies and correlates with imaging findings, guiding diagnosis and management.

Executive Summary：
Dr Margitta Seeck is full professor of Neurology at the University of Geneva, Switzerland. She is director of the presurgical epilepsy program Geneva-Lausanne, which became a reference center for difficult-to-treat epilepsies in adults and children. She also heads the in- and outpatient unit of the EEG and Epilepsy Unit of the University Hospital of Geneva and established the first "first seizure clinic" with inpatient monitoring in the world. She is past president of the Swiss Neurophysiological Society but she is still actively involved in teaching of EEG and epileptology. As Editor-in-chief for Clinical Neurophysiology Practice she is also part of the Executive Committee of the International Federation of Neurology. Her main interests are epilepsy surgery, EEG and EEG-based imaging in epilepsy, neurophysiology of intracranial EEG recordings. She is author of more than 300 papers and bookchapters on epilepsy and EEG in national and international journals, serves on the board of the European Academy of Neurology and several editorial boards of epilepsy journals, and is expert for the Swiss national science foundation and research agencies of other European and non-European countries.

Lecture Abstract：
EEG after a first seizure is the key exam which determines if the patient suffers from an underlying (beginning) epilepsy, an acute symptomatic seizure or a non-epileptic event. We will compare the yield of a first routine EEG, the importance of timing, and compare it with the yield of sleep-EEG or even overnight EEG.

Executive Summary：
Dr. Chin-Wei Huang, MD, PhD, CSCN Diplomate (EEG), FAES
Professor and Director, Department of Neurology
Head, Division of Epileptology
National Cheng Kung University Hospital, Tainan, Taiwan

Dr. Chin-Wei Huang is a Professor and Director of the Department of Neurology at National Cheng Kung University (NCKU) in Tainan, Taiwan, where he also heads the Division of Epileptology. He earned his MD from Kaohsiung Medical University and his PhD from the Institute of Clinical Medicine at NCKU. His postdoctoral and fellowship training took place in Japan and Canada, including at the University of British Columbia and the University of Western Ontario.

A board-certified neurologist and neurocritical care specialist, Dr. Huang is also a diplomate in EEG from the Canadian Society of Clinical Neurophysiologists. He previously served as President of the Taiwan Epilepsy Society. He is an active member of the Medical Therapies Task Force of the International League Against Epilepsy (ILAE) and is involved in EEG education and international epilepsy initiatives. He holds memberships in several prestigious neurological and neurophysiological societies globally, including the American Epilepsy Society.

Dr. Huang's research centers on epileptogenesis and clinical epilepsy, with a strong track record of national and international publications and numerous awards. He has cultivated active research collaborations with institutions in Japan, Canada, the United States, and the United Kingdom.

Lecture Abstract：
Status epilepticus (SE) is a life-threatening neurological emergency, especially in critically ill patients. It is broadly classified into convulsive (CSE) and nonconvulsive status epilepticus (NCSE), the latter often presenting without clear clinical signs and requiring EEG for diagnosis. EEG is essential not only for confirming SE but also for identifying seizure onset patterns, excluding mimics such as pseudostatus, and guiding urgent treatment. In NCSE, particularly in comatose patients, EEG interpretation can be complex. While ictal patterns with spatiotemporal evolution or epileptiform discharges >2.5 Hz suggest NCSE, other ambiguous patterns, such as periodic or rhythmic discharges, require additional criteria (e.g., clinical signs, drug response) for diagnosis. Updated frameworks like the Salzburg Criteria and ACNS terminology have enhanced diagnostic precision, though validation in deep coma remains ongoing. Continuous EEG aids prognosis by predicting seizure recurrence, ischemia, coma recovery, but its mortality benefit remains unproven. This presentation will review EEG features in CSE and NCSE, diagnostic criteria in critical care, and emerging prognostic roles of EEG in neurocritical monitoring.

Executive Summary：
Dr. Wei-Ting Chiu is a neurologist and critical care specialist with over ten years of clinical and academic experience in neurocritical care and intensive care medicine. Trained at Shuang Ho Hospital from residency through attending physician, Dr. Chiu advanced her expertise at Columbia University (2018–2019) in the Neuro-ICU, focusing on neurocritical care, continuous EEG monitoring, and epilepsy control. She collaborated with Dr. Classan on long-term EEG monitoring for seizure management. Upon returning to Taiwan, she continued her research in the Neuro-ICU, particularly in therapeutic hypothermia for post-cardiac arrest patients and multimodal neuroprognostication, integrating EEG, neuroimaging, and ultrasonography to improve clinical outcomes.

Her research specialization lies in neurocritical care monitoring, therapeutic hypothermia, EEG and neurophysiological signal analysis, and multimodal prognostic assessment. Dr. Chiu has authored multiple peer-reviewed publications bridging clinical practice and translational research in critical care neurology. Her works reflect a strong commitment to improving prognostic accuracy and developing evidence-based strategies in the management of critically ill neurological patients.

Lecture Abstract：
This multicenter retrospective study analyzed 386 episodes of refractory status epilepticus (RSE) treated in ICUs across high- and upper-middle-income countries between 2015 and 2018. Midazolam was used initially in 69% of cases and propofol in 31%; around one-third of patients in both groups required a second anesthetic. Baseline features and outcomes were similar regardless of the chosen drug. Breakthrough and withdrawal seizures were linked to prolonged need for continuous IV anesthetics, while extended EEG monitoring was associated with shorter infusion duration, especially in high-income settings. At discharge, 21% of patients achieved good functional outcomes and 28% had died. Overall, midazolam and propofol were equally effective for RSE, and protocol-based, EEG-guided management may optimize treatment.