title: Epilepsy surgery in India: All India Institute of Medical Sciences experience.
abstract: OBJECTIVE
  Surgical treatment of epilepsy should be considered an important alternative to medical therapy. The identification of a suitable candidate, pre-operative evaluation requires a multidisciplinary team. The specific diagnostic studies required depend on the operative strategy and objective of surgical treatment.
  
  
  METHODS
  In twenty patients with medically intractable epilepsy, who had clinical evaluation, electroencephalography (EEG), video-EEG monitoring using scalp electrodes, high resolution magnetic resonance imaging (MRI), neuropsychology, single photon emission computed tomography (SPECT) was done to localise the seizure focus. If the investigations were concordant resective surgery was performed. In case of frequent falls, atonic and tonic seizures, with generalised/multifocal discharges on EEG, a callostomy was done. Surgical outcome was assessed using Engel's 4 point scale.
  
  
  RESULTS
  In 18 patients the seizure focus was localised, 13 had temporal lobectomy, five extra-temporal resection, and two had callosotomy. Fifteen patients had a follow-up of more than eight months, mean 20.5 (range 8-35 months), 13 had outcome I (seizure free), two had outcome II (occasional seizures), one-outcome III. Three were lost to follow-up and one patient died. There were no major post-operative complications.
  
  
  CONCLUSIONS
  Surgical treatment of epilepsy is a safe, effective mode of therapy. Suitable candidates should be identified early and referred to appropriate centres.
authors.affiliation: Dept. of Neurology, All India Institute of Medical Sciences, New Delhi.
authors.forename: M
authors.initials: M
authors.lastname: Bhatia
authors.forename: V P
authors.initials: VP
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Jain
authors.forename: S
authors.initials: S
authors.lastname: Gaekwad
authors.forename: C S
authors.initials: CS
authors.lastname: Bal
authors.forename: C
authors.initials: C
authors.lastname: Sarkar
authors.forename: M V
authors.initials: MV
authors.lastname: Padma
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: H H
authors.initials: HH
authors.lastname: Dash
authors.forename: M C
authors.initials: MC
authors.lastname: Maheshwari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged