Epilepsy, a neurological illness defined by recurrent seizures, can significantly affect an individual’s quality of life. For some patients, traditional treatments like medications may not provide adequate relief. In such cases, epilepsy surgery emerges as a viable option, offering hope for a seizure-free future. This blog aims to shed light on the intricacies of epilepsy surgery in India, covering the procedure itself, success rates, and associated costs.

Epilepsy surgery involves the removal or alteration of specific brain areas responsible for triggering seizures. This procedure is typically considered when seizures originate in a well-defined and accessible region of the brain. Advanced diagnostic techniques, such as EEG (electroencephalogram) and imaging studies, help identify the precise location, ensuring a targeted surgical approach.

The success of epilepsy surgery is contingent on various factors, including the type of epilepsy, the location of seizure onset, and the patient’s overall health. Studies suggest that a significant percentage of individuals experience a substantial reduction in seizure frequency or complete seizure freedom following surgery. Success rates can vary, and patients must thoroughly evaluate their suitability for the procedure.

One of the key aspects individuals contemplate when considering epilepsy surgery is the associated cost. India has emerged as a preferred medical hub due to its advanced healthcare infrastructure and cost-effective treatments. The cost of epilepsy surgery in India is influenced by factors such as the type of surgery, hospital facilities, and the medical team’s expertise. Comparatively, the expenses in India are often lower than in many Western countries, making it the finest option for international patients seeking high-quality care without a hefty price tag.

Epilepsy surgery involves careful consideration and collaboration between patients, their families, and healthcare professionals. It is essential to consult with experienced neurosurgeons and epileptologists who can provide personalized guidance based on individual medical histories and diagnostic findings. Moreover, gaining insights into the success rates and costs associated with epilepsy surgery in India empowers anyone to make informed decisions regarding their treatment path.

Epilepsy surgery in India represents a promising avenue for those seeking effective seizure management. This blog serves as a comprehensive guide, offering valuable insights to aid individuals in navigating the complexities of epilepsy surgery and ultimately striving for an improved quality of life.

What Is Epilepsy Surgery?

Epilepsy Surgery Cost In India

Epilepsy surgery is a medical procedure performed to treat epilepsy, a neurological illness characterized by recurrent, unprovoked seizures. Seizures are caused due to abnormal electrical activity in the brain. While many people with epilepsy can manage their condition with medication, some individuals may continue to experience seizures despite trying various remedies.

Epilepsy surgery is considered when medications are ineffective in controlling seizures, and the seizures significantly impact the individual’s quality of life. Epilepsy surgery aims to identify & eliminate or disconnect the specific area of the brain generating seizures, known as the “seizure focus” or “epileptogenic zone.”

Also Read: Epilepsy: Causes, Diagnosis, Treatment, & More

Epilepsy Surgery Cost In India

Epilepsy surgery cost in India can range between Rs. 3.5 Lakh and Rs. 15 lakhs (USD 3000 to USD 18,000). This includes the cost of evaluation and the surgery itself. Epilepsy surgery costs in India are reasonable and affordable compared to other developed countries such as the US and the UK. However, the same procedure may cost between $15000 and $25000 in the US.

Epilepsy surgery cost in India depends on several factors, such as:

– The type of epilepsy surgery performed

– The type of hospital and admission room

– The duration of hospital stay

– The fees of the doctors and other staff

– The cost of pre-operative and post-operative tests and medications

– The cost of any complications or additional procedures

The most common kinds of epilepsy surgery performed in India are:

– Resective surgery: This involves removing a small part of the brain that is causing seizures, such as the temporal lobe, the frontal lobe, or the parietal lobe. This is usually done for patients who have focal epilepsy, which means that their seizures start from one area of the brain. The average expenses for resective surgery in India are approximately Rs.250000. The maximum amount to be paid for resective surgery in India rises to Rs.427900.

– Disconnection surgery: This involves cutting or disconnecting some of the nerve fibers that connect different parts of the brain, such as the corpus callosum or the multiple subpial transection. This is usually done for patients who have generalized epilepsy, which means that their seizures affect both sides of the brain. The average expenses for disconnection surgery in India are approximately Rs.300000. The maximum amount to be paid for disconnection surgery in India rises up to Rs.500000.

– Neuromodulation surgery: This involves implanting a device that can stimulate or inhibit certain areas of the brain or nerves that are involved in seizure generation, such as the vagus nerve stimulator (VNS), the deep brain stimulator (DBS), or the responsive neurostimulator (RNS). This is usually done for patients who have drug-resistant epilepsy that cannot be treated by resective or disconnection surgery. The average expenses for neuromodulation surgery in India are approximately Rs.600000. The maximum amount to be paid for neuromodulation surgery in India rises up to Rs.1000000.

The cost of epilepsy surgery evaluation in India also varies depending on the complexity and duration of the tests required. The assessment may include:

– A detailed medical history and physical examination

– A video-electroencephalogram (VEEG) to record the brain waves and seizures

– A magnetic resonance imaging (MRI) scan to visualize the structure and function of the brain

– A positron emission tomography (PET) scan or a single-photon emission computed tomography (SPECT) scan to measure the blood flow & metabolism of the brain

– A neuropsychological assessment to evaluate the cognitive and behavioral functions of the patient

– A Wada test or a functional MRI (fMRI) to determine the language and memory functions of each hemisphere of the brain

– A magnetoencephalography (MEG) or an electrocorticography (ECoG) to map the electrical activity of the brain with high precision

The average expenses for a simple epilepsy surgery evaluation in India are approximately Rs.50000. The maximum amount to be paid for a simple epilepsy surgery evaluation in India rises up to Rs.100000.

The average expenses for a complex epilepsy surgery evaluation in India are approximately Rs.100000. The maximum amount to be paid for a difficult epilepsy surgery evaluation in India rises up to Rs.200000.

The average expenses for a very complex epilepsy surgery evaluation in India are approximately Rs.200000. The maximum amount to be paid for a very complex epilepsy surgery evaluation in India rises up to Rs.400000.

Epilepsy Surgery Success Rate For Its Different Types

The success rate of epilepsy surgery depends on several factors, such as the type of surgery, the location & extent of the seizure focus, the age and overall health of the patient, and the definition of success. Success can mean different things to different people, such as being completely seizure-free, having fewer or less severe seizures, reducing medication use or side effects, improving quality of life or cognitive function, or reducing the risk of sudden death.

According to various studies, epilepsy surgery can have a high success rate for some people, especially those who have temporal lobe epilepsy, which is the most common type of epilepsy that responds well to surgery. Temporal lobe epilepsy affects the part of the brain that controls memory, language, and emotions. Studies have shown that about 70% of people who have temporal lobe surgery become seizure-free, with 50% remaining seizure-free after 10 years. However, doctors will only recommend surgery for those who are likely to benefit from it and who have a clear and localized seizure focus.

Other types of epilepsy surgery may have lower or variable success rates depending on the individual case. For example, laser interstitial thermal therapy (LITT) is a less invasive procedure that uses a laser to destroy a small part of brain tissue that causes seizures. This procedure may be suitable for people with small and deep-seated lesions that are difficult to reach by conventional surgery. The success rate of LITT may range from 50% to 80%, depending on the location and size of the lesion.

Deep brain stimulation (DBS) is another type of epilepsy surgery that involves implanting a device that propels electrical impulses to specific parts of the brain to disrupt seizure activity. DBS may be an option for people who have generalized or multifocal epilepsy that cannot be treated by resective surgery. The success rate of DBS may vary from 40% to 70%, depending on the stimulation parameters and the follow-up duration.
Corpus callosotomy is a type of epilepsy surgery that involves cutting or removing the part of the brain that connects the two hemispheres. This procedure may reduce the spread of seizures from one side of the brain to the other and prevent drop attacks, which are sudden falls due to loss of muscle tone. Corpus callosotomy does not usually stop seizures completely, but it may reduce their frequency and severity by 50% to 80%.

Epilepsy Surgery Side Effects

While epilepsy surgery can be effective in reducing or eliminating seizures for some individuals, like any surgical procedure, it comes with potential side effects and risks. It’s essential to discuss these thoroughly with your healthcare team before making a decision. Here are some possible side effects associated with epilepsy surgery:

1. Cognitive Changes: Depending on the location of the brain where the surgery is performed, there is a risk of cognitive changes. This may include memory issues, changes in attention, or alterations in language skills. The extent of these changes can differ from person to person.

2. Speech and Language Difficulties: Surgery in brain areas responsible for language functions can lead to speech and language difficulties. This risk is more significant for surgeries involving the dominant hemisphere of the brain, which is generally the left hemisphere for right-handed individuals.

3. Motor Skill Impairments: Surgery in regions controlling motor functions can result in motor skill impairments. This might affect coordination, strength, or fine motor skills.

4. Visual Disturbances: There is a risk of visual disturbances depending on the brain area involved. This could include changes in vision or visual field deficits.

5. Personality and Emotional Changes: Surgery in certain brain regions can impact personality and emotional regulation. Some patients may experience changes in mood, behavior, or emotional expression.

6. Risk of Infection: As with any surgery, there is a risk of infection. The surgical site is vulnerable to disease, and preventive measures are taken to minimize this risk.

7. Postoperative Seizures: Individuals may sometimes experience seizures after surgery. The goal of surgery is often seizure reduction rather than complete elimination.

8. Complications with Wound Healing: Any surgical procedure risks complications related to wound healing. This can include issues such as infection or poor healing.

9. Long-Term Rehabilitation: Long-term rehabilitation may be necessary to help individuals regain or adapt to certain functions based on the extent of the surgery and the resulting neurological changes.

It’s crucial to note that not everyone will experience these side effects, and the benefits of epilepsy surgery can outweigh the risks for many individuals, especially when seizures are severely impacting quality of life. The decision to undergo epilepsy surgery should be made after careful consideration, and individuals should work closely with their medical team to weigh the potential risks & benefits based on their specific case.

Best Hospitals For Epilepsy Surgery In India

1) Indraprastha Apollo Hospital, New Delhi

2) Kokilaben Dhirubhai Ambani Hospital, Mumbai

3) BLK Super Speciality Hospital

4) Apollo Hospitals, Greams Road, Chennai

5) Artemis Hospital

6) Fortis Memorial Research Institute, Gurgaon

7) Medanta – The Medicity, Gurgaon

8) Manipal Hospital (Old Airport Road), Bangalore

9) AIIMS, Delhi

10) Apollo Hospitals, Jubilee Hills, Hyderabad

Benefits Of Epilepsy Surgery

Epilepsy surgery can be a valuable treatment option for individuals with epilepsy who do not respond well to medication. While it may not be suitable for everyone with epilepsy, for those who are candidates, the benefits of epilepsy surgery can be significant. Here are some of the potential benefits:

1. Seizure Control: One of the primary goals of epilepsy surgery is to control or reduce the frequency and severity of seizures. Many individuals who undergo epilepsy surgery experience a significant reduction in the number of seizures or even become seizure-free.

2. Improved Quality of Life: For people with drug-resistant epilepsy, seizures can significantly impact their daily lives, affecting employment, relationships, and overall well-being. Achieving better seizure control through surgery can lead to an improved quality of life.

3. Reduced Medication Dependency: Some individuals with epilepsy require high doses of antiepileptic medications, which can have side effects. Epilepsy surgery may allow for a reduction in medication dosage or, in some cases, complete discontinuation of medication, leading to a better quality of life without the side effects of long-term medication use.

4. Cognitive and Behavioral Benefits: In some instances, epilepsy surgery can improve cognitive function and behavior. This is particularly relevant for individuals whose seizures originate in areas of the brain responsible for critical cognitive functions.

5. Enhanced Independence: Seizures can limit a person’s independence and ability to drive, swim, or live alone. Successful epilepsy surgery can increase independence by reducing the risk of seizures.

6. Prevention of Injury: Seizures can pose a risk of injury, especially if they lead to falls or accidents. By reducing or eliminating seizures, epilepsy surgery can help prevent injuries and improve overall safety.

7. Improved Mental Health: Living with epilepsy can affect mental health due to the unpredictability of seizures and their impact on daily life. Achieving better seizure control through surgery can alleviate the psychological burden and improve mental health.

8. Long-Term Cost Savings: While epilepsy surgery may involve significant costs, achieving better seizure control can lead to long-term cost savings by limiting the need for expensive medications, emergency room visits, and other healthcare resources associated with uncontrolled seizures.

What To Expect Before, During & After Epilepsy Surgery?

Epilepsy surgery is a treatment option for individuals with epilepsy who do not respond well to medications. The decision to undergo epilepsy surgery is typically made after thorough evaluation and discussion between the patient, their family, and a multidisciplinary team of healthcare professionals. The process involves several stages, including pre-surgical evaluation, surgery, and post-surgical recovery. Here’s a detailed overview of what to expect before, during, and after epilepsy surgery:

 Before Epilepsy Surgery:

Before undergoing epilepsy surgery, a person needs to undergo several tests to determine whether they are eligible and what type of surgery would be best for them. These tests may include:

– Electroencephalogram (EEG): This measures the brain’s electrical activity using electrodes attached to the scalp. It can help identify where and how often seizures occur.

– MRI: It uses magnetic fields and radio waves to create detailed brain images. It can help locate any lesions or abnormalities that cause seizures.

– Positron emission tomography (PET) scan: This uses a radioactive substance injected into the bloodstream to show how different parts of the brain use glucose (sugar). It can help identify areas of low or high metabolism related to seizure activity.

– Single-photon emission computed tomography (SPECT) scan: This uses a radioactive substance infused into the bloodstream to show how blood flows in different parts of the brain. It can help pinpoint where seizures start and spread.

– Neuropsychological testing: This involves assessing various aspects of cognitive function, such as memory, language, attention, problem-solving, and personality. It can help evaluate how surgery may affect these functions.

– Wada test: This involves injecting an anesthetic into one side of the brain through a catheter inserted into an artery in the groin. It can help determine which side of the brain is dominant for language and memory functions.

– Intracranial EEG: This involves placing electrodes directly on or inside the brain through small holes drilled in the skull. It can provide more precise information about the location and extent of the seizure focus.

 During Epilepsy Surgery:

1. Preparation:

   – Before surgery, the surgical team prepares the patient, and general anesthesia is administered.

2. Brain Surgery:

   – The type of surgery depends on the identified seizure focus. Common procedures include resection (removing the seizure focus), disconnection (severing connections causing seizures), or stimulation (implanting devices like a vagus nerve stimulator or responsive neurostimulation).

3. Monitoring:

   – Intraoperative EEG may monitor brain activity during surgery, ensuring the surgical team targets the correct areas.

4. Awakening Phase:

   – Some surgeries require the patient to be awake during certain parts to assess brain function in real-time, particularly for procedures involving speech or motor areas.

 After Epilepsy Surgery:

1. Immediate Postoperative Period:

   – Patients are closely watched in the recovery room & may spend a day or more in an intensive care unit (ICU) for observation.

2. Hospital Stay:

   – The length of hospital stay differs based on the type of surgery and individual recovery. It can range from a few days to a couple of weeks.

3. Postoperative Care:

   – Medications are often continued postoperatively to manage pain and prevent infection.

4. Follow-up:

   – Regular follow-up appointments are scheduled to monitor recovery, adjust medications, and assess the impact of surgery on seizure control.

5. Rehabilitation and Recovery:

   – Rehabilitation may be recommended to address any functional deficits resulting from surgery. This could include physical, occupational, or speech therapy.

6. Seizure Monitoring:

   – Long-term seizure monitoring is conducted to assess the effectiveness of surgery. It may take some time for the full benefits to become apparent.

It’s important to note that outcomes vary; not everyone may experience complete seizure freedom. The decision to undergo epilepsy surgery is a complex one and should involve a detailed discussion with a healthcare team experienced in epilepsy management.

Conclusion

In conclusion, epilepsy surgery in India is a transformative option for individuals struggling with uncontrolled seizures. The procedure involves identifying and removing the brain region responsible for seizures, offering hope for a life free from the constraints of epilepsy. Success rates vary but are generally promising, with many patients experiencing a significant reduction or complete cessation of seizures. While the cost of epilepsy surgery in India is relatively lower than in many Western nations, it’s crucial to consider the comprehensive care provided by experienced medical professionals. 

This surgery addresses the symptoms and enhances the overall quality of life. As with any medical intervention, thorough consultation with qualified healthcare professionals is imperative to determine the suitability of surgery and to understand the potential benefits and risks tailored to individual cases.

Epilepsy, a neurological disorder affecting millions worldwide, imposes significant financial burdens on individuals seeking life-changing surgeries. In India, where healthcare costs can be substantial, crowdfunding platform emerges as a powerful tool to alleviate the financial strain associated with epilepsy surgery. 

Crowdfunding platforms provide a global reach, tapping into networks beyond geographical boundaries. This widens the pool of potential donors, increasing the chances of reaching the fundraising goal. Friends, family, and even strangers can contribute, turning the campaign into a collective effort. Fundraising for medical emergencies is faster and easier with online platforms.