A survey of epilepsy surgery in India

• We gathered information about epilepsy surgery (ES) from centers across India.
• On average, 420 ES were being carried out each year in India.
• During last two decades, there was a steady increase in the number of ES in India.
• Compared to 3-fold increase of temporal lobe ES, extratemporal ES increased 7-fold.
• ES temporal trend in India is in contrast to experience of high-income countries.

PurposeEpilepsy surgery (ES) not only remains one of the most underutilized of all accepted medical interventions, but there has also been a decrease in referrals for ES in recent years in high-income countries. We undertook this study to determine the temporal trends of ES and its current state in India.MethodsWe asked the directors of epilepsy centers across India to complete an online questionnaire about the number and type of ES procedures carried out from 1995 or commencement of the program till December 2012.ResultsDuring the 18-year period, a total of 4252 ES have been undertaken. On an average, 420 ES were being carried out each year in India. Three-fourths of resective surgeries involved the temporal lobe. Although majority of patients were selected for ES by noninvasive strategies, 13 centers had performed long-term invasive EEG monitoring to select complex cases. In between 1995–2000 and 2007–2012, the number of ES carried out in India registered an increase by three-fold.ConclusionsA steadily increasing number of eligible patients with drug-resistant epilepsy in India are undergoing ES in recent years. This temporal trend of ES in India is in contrast to the recent experience of high-income countries.