Epilepsy Surgery Evaluation in Ahmedabad

Comprehensive pre-surgical workup and stereo-EEG evaluation for seizure freedom by NIMHANS experts

Surgery Evaluation: +91 87809 66624

For patients with drug-resistant epilepsy, surgery offers the best chance of achieving seizure freedom. At Gujarat Epilepsy & Neuro Clinic, we provide comprehensive epilepsy surgery evaluation services to determine if surgical intervention could help you live a seizure-free life.

Dr. Rutul Shah and Dr. Abhishek Gohel, both NIMHANS-trained epileptologists with specialized training from Amrita Institute, Kochi and Amrita Kochi respectively, bring extensive experience in pre-surgical evaluation and work closely with leading neurosurgical centers to coordinate your complete care.

Success Rates of Epilepsy Surgery

Studies show that 60-80% of carefully selected patients become seizure-free after epilepsy surgery. For temporal lobe epilepsy, the most common surgical condition, success rates can reach up to 85% in ideal candidates. This makes surgery one of the most effective treatments available for drug-resistant epilepsy.

Who is a Candidate for Epilepsy Surgery?

Not all patients with epilepsy are candidates for surgery, but those who meet specific criteria may benefit tremendously. Surgery evaluation is recommended for patients who:

  • Have drug-resistant epilepsy: Seizures continue despite trying at least two appropriate anti-seizure medications
  • Have focal seizures: Seizures that originate from a specific, identifiable area of the brain
  • Have an identifiable seizure focus: The location where seizures start can be clearly mapped
  • Have adequate seizure frequency: Enough seizures to significantly impact quality of life
  • Are willing to undergo evaluation: Comprehensive testing and potential surgical risks are acceptable
  • Have failed medical optimization: Multiple medication trials have been unsuccessful

Specific Conditions That May Benefit from Surgery

  • Temporal lobe epilepsy with hippocampal sclerosis
  • Focal cortical dysplasia (FCD)
  • Cavernous malformations causing seizures
  • Low-grade tumors associated with epilepsy
  • Post-stroke or traumatic epilepsy with clear lesions
  • Tuberous sclerosis complex with dominant tubers

Our Comprehensive Pre-Surgical Evaluation Process

The journey toward epilepsy surgery begins with a thorough evaluation to determine if you are a suitable candidate. Our systematic approach ensures that no detail is overlooked in your assessment.

1

Initial Consultation & History

Detailed seizure history, medication trials, impact on quality of life, and comprehensive neurological examination. We review all previous medical records and imaging studies.

2

Video-EEG Monitoring

Long-term video-EEG monitoring to capture and analyze seizure events, localize the seizure focus, and characterize seizure semiology in detail.

3

High-Resolution Brain MRI

3-Tesla MRI with epilepsy protocol including specialized sequences to identify structural abnormalities, hippocampal sclerosis, or subtle lesions.

4

Neuropsychological Testing

Comprehensive cognitive assessment to evaluate memory, language, and other brain functions, helping predict surgical outcomes and plan rehabilitation.

5

Functional Brain Imaging

PET scan or ictal SPECT to identify areas of abnormal brain metabolism and blood flow during seizures, providing additional localization information.

6

Multidisciplinary Team Review

Case presentation to our epilepsy surgery team including neurologists, neurosurgeons, radiologists, and neuropsychologists for comprehensive evaluation.

Phase 2 Evaluation: Advanced Monitoring

Some patients require additional invasive monitoring to precisely locate the seizure focus before surgery can be recommended:

Stereo-EEG (sEEG)

When non-invasive testing doesn't provide sufficient information, stereo-EEG may be recommended. This advanced technique involves:

  • Precise electrode placement: Multiple depth electrodes are placed directly into brain tissue using stereotactic guidance
  • Detailed brain mapping: Direct recording from deep brain structures and cortical areas not accessible with surface electrodes
  • Seizure localization: Precise identification of seizure onset and spread patterns
  • Functional mapping: Testing of brain functions (language, memory, motor) to avoid critical areas during surgery
  • Safety profile: Minimally invasive compared to traditional grid electrode placement

When is Stereo-EEG Needed?

  • Multiple possible seizure foci identified on non-invasive testing
  • Seizures appear to originate from deep brain structures
  • Complex seizure patterns requiring detailed mapping
  • Need to evaluate both hemispheres of the brain
  • Previous surgery with recurrent seizures

Types of Epilepsy Surgery

Based on evaluation results, different surgical approaches may be recommended:

Surgery Type Description Best Candidates Success Rate
Temporal Lobectomy Removal of part of the temporal lobe, often including the hippocampus Temporal lobe epilepsy with hippocampal sclerosis 70-85%
Focal Resection Removal of specific brain area where seizures originate Well-defined lesions causing epilepsy 60-80%
Laser Ablation (LITT) Minimally invasive destruction of seizure focus using laser Small, deep lesions; previous surgery candidates 50-70%
Corpus Callosotomy Disconnection of brain hemispheres to prevent seizure spread Generalized epilepsy with drop attacks 60-80% reduction
Hemispherectomy Disconnection or removal of one brain hemisphere Severe epilepsy affecting one hemisphere in children 80-90%

The Gujarat Epilepsy & Neuro Clinic Advantage

Our comprehensive approach to epilepsy surgery evaluation sets us apart:

What Makes Our Evaluation Special

  • NIMHANS-Trained Expertise: Both our doctors completed their training at India's premier neurological institute
  • Epilepsy Fellowship Training: Specialized post-doctoral training in epileptology
  • Comprehensive Care: Complete evaluation from initial assessment through post-surgical follow-up
  • Advanced Technology: State-of-the-art video-EEG monitoring and imaging facilities
  • Collaborative Approach: Close partnerships with leading neurosurgical centers
  • Patient-Centered Care: Thorough counseling and shared decision-making throughout the process
  • Local Accessibility: Comprehensive evaluation available in Ahmedabad

Surgical Referral Network

Important Note: Our clinic conducts comprehensive pre-surgical evaluation and coordinates with leading epilepsy surgery centres across India for surgical intervention when indicated. We evaluate and refer for surgery — we do not perform the surgical procedures ourselves.

We maintain strong referral relationships with premier neurosurgical centers including:

  • NIMHANS, Bangalore — for complex stereo-EEG and surgical procedures
  • SCTIMST, Trivandrum — for advanced surgical techniques
  • Leading centers in Mumbai and Delhi — ensuring you have access to the best surgical options
  • Other specialized epilepsy surgery centers — based on your specific needs and location preferences

Our role is to thoroughly evaluate your candidacy, complete the necessary pre-surgical workup, and then coordinate your care with the most appropriate surgical center for your specific condition.

The Evaluation Timeline

Understanding the timeline helps you plan for the evaluation process:

Phase Duration Activities
Initial Assessment 1-2 weeks Consultation, record review, preliminary testing
Video-EEG Monitoring 3-7 days Inpatient monitoring to capture seizures
Additional Testing 2-4 weeks MRI, PET/SPECT, neuropsychological testing
Team Review 1-2 weeks Multidisciplinary case discussion and recommendations
Results Discussion 1 day Detailed consultation about findings and options

Total evaluation time is typically 6-8 weeks from initial consultation to final recommendations. Some patients may require additional invasive monitoring, which can extend the timeline by 2-4 weeks.

Our Pre-Surgical Evaluation Experts

Both Dr. Rutul Shah and Dr. Abhishek Gohel have extensive experience in epilepsy surgery evaluation and work closely with premier neurosurgical centers to coordinate comprehensive care.

Dr. Rutul Shah

DM Neurology (NIMHANS - AIR 1)
PDF Epilepsy (Amrita Institute, Kochi)

Expert in pre-surgical epilepsy evaluation, video-EEG interpretation, and surgical candidacy assessment. Extensive experience in coordinating care with neurosurgical teams and post-surgical management.

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Dr. Abhishek Gohel

DM Neurology (NIMHANS)
PDF Epilepsy (Amrita Kochi)

Specialist in drug-resistant epilepsy evaluation, stereo-EEG candidate assessment, and complex case management. Particular expertise in evaluating challenging cases requiring invasive monitoring.

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Frequently Asked Questions About Epilepsy Surgery Evaluation

How do I know if I'm a candidate for epilepsy surgery?
You may be a candidate if you have drug-resistant epilepsy (seizures continue despite trying 2+ medications), focal seizures that seem to come from one area of the brain, and seizures that significantly impact your quality of life. The only way to know for certain is through comprehensive evaluation. Our epilepsy specialists can assess your specific situation and recommend whether surgery evaluation is appropriate.
Is epilepsy surgery safe? What are the risks?
Modern epilepsy surgery is generally safe when performed at experienced centers. Risks vary by surgery type and location but may include infection, bleeding, neurological deficits, or memory changes. The specific risks depend on the type and location of surgery planned. During evaluation, we thoroughly discuss potential risks and benefits specific to your case, helping you make an informed decision.
What is stereo-EEG and when is it needed?
Stereo-EEG (sEEG) is an advanced monitoring technique where multiple thin electrodes are placed precisely into the brain to record electrical activity directly from brain tissue. It's needed when non-invasive tests don't provide clear answers about where seizures start, when multiple areas might be involved, or when seizures appear to come from deep brain structures. It's safer and less invasive than older monitoring techniques.
How long does the surgery evaluation process take?
The complete evaluation typically takes 6-8 weeks from initial consultation to final recommendations. This includes video-EEG monitoring (3-7 days), additional testing (MRI, PET scans, neuropsychological testing), and team review. Some patients may need invasive monitoring, which can extend the timeline. We'll give you a personalized timeline during your initial consultation.
What if I'm not a candidate for surgery?
Not all patients with drug-resistant epilepsy are surgical candidates, but that doesn't mean there are no options. We may recommend medication optimization, clinical trials of new drugs, or referral for other treatments. Sometimes patients who aren't candidates initially may become candidates later as technology advances or their condition changes. We'll work with you to find the best possible treatment approach.
Will my insurance cover epilepsy surgery evaluation?
Most insurance plans cover medically necessary epilepsy surgery evaluation and surgery when appropriate. We work with major insurance providers and will help verify your coverage and obtain necessary pre-authorizations. Our team can provide detailed cost estimates and help you understand your insurance benefits. Don't let insurance concerns prevent you from exploring this potentially life-changing treatment option.

Medical Disclaimer: The information on this website is for educational purposes only and should not be considered medical advice. Individual treatment outcomes vary. Always consult a qualified healthcare provider for diagnosis and treatment decisions. In case of a medical emergency, call 108 or visit your nearest emergency department.

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