Best Epilepsy Treatment in India [Among the Best Epilepsy doctors in India]
Dr. Siddharth Kharkar, MBBS, MD Neurology (USA), MHS
Dr. Siddharth Deepak Kharkar
Recognized as one of the
Best Neurologists in Mumbai
By India Today magazine (2020, 2021, 2024) & Outlook India Magazine (2020, 2024).
Best Epilepsy Treatment in India at Mumbai, including Epilepsy Surgery
Dr. Siddharth Kharkar is an internationally trained Epilepsy specialist in Mumbai, India who runs the NeuroPlus Epilepsy & Parkinson’s clinics. He is noted as one of the best Epilepsy doctors in India. He provides the best Epilepsy treatment in India itself, including Epilepsy surgery in India. He is available at Nanavati Hospital in Mumbai, India and in clinics around Mumbai.
He finished his MBBS from KEM hospital, MHS from Johns Hopkins University, USA his MD Neurology from Drexel University, USA. He completed his 2-year fellowship in Epilepsy surgery from the University of California at San Francisco (UCSF), USA which is one of the centers offering best epilepsy treatment in the world.
He was part of the Epilepsy faculty at the University of Alabama at Birmingham (UAB) before returning to India. Since then, He has been recognized as one of the best neurologists in Mumbai by India Today & Outlook India magazines.
As one of the best epilepsy doctors in India, Dr. Siddharth Kharkar conducts medically resistant Epilepsy treatment specialist clinics.
This means that many of the patients with Epilepsy who come to this clinic have Epilepsy that is not controlled with medications.
This can happen due to many reasons.
- Misdiagnosis:
For example, a patient who is passing out repeatedly may have a cardiac problem, instead of Epilepsy.
2. Improper characterization of Epilepsy:
Epilepsy is of many different types. For the best Epilepsy treatment in India or any other city to be given, the exact type of Epilepsy should be identified. This leads to the correct choice of medications.
For example, in a condition called Lennox-Gastaut Syndrome, a medication called Clobazam may be the best treatment for seizures.
3. Incomplete explanation given to the patient:
Very often, patients don’t take their medications correctly either because they are disturbed by their diagnosis and want to deny it. Sometimes, they may not understand how exactly to take their medications.
The best Epilepsy treatment in India does not end with a mathematical calculation of medication names and dosages.
It is very important to explain Epilepsy completely to the patient. This helps in settling emotional turmoil and helps in taking antiepileptic medications regularly.
4. Medically resistant Epilepsy needing Epilepsy surgery in India at Mumbai:
In about 20-30% of patients, Epilepsy is not completely controlled by medications. Seizures keep happening even if medications are changed multiple times.
In such cases, a different thought process is required. Such cases may require the removal of the diseased part of the brain, the part that is not working and producing seizures.
If done correctly, Epilepsy surgery success rates are very high.
Best Epilepsy Treatment in India at Mumbai Services
The following services are provided at the NeuroPlus clinics at Nanavati Hospital in Mumbai, Thane and Virar:
1. Evaluation & Characterization of Seizures by Epilepsy specialist in India:
- The best epilepsy treatment in India begins with evaluation of epileptic seizures, including differentiation from other disorders which can mimic seizures including syncope and non-epileptic seizures (psychogenic seizures, PNES)
- Sub-categorization and identification of pathologies including temporal lobe epilepsy, occipital lobe epilepsy, focal cortical dysplasia, hippocampal sclerosis or mesial temporal sclerosis etc.
- Characterization of seizures, with Video EEG monitoring in Mumbai if needed.
- Defining the Epilepsy syndrome e.g. Lennox-Gastaut, Panayitopoulos syndrome etc. This helps to provide the best treatment for Epilepsy.
2. Antiepileptic medication adjustment
- Selecting the first anti-epileptic medication is relatively easy. However, if 2 or more anti-epileptic medications need to be given for seizures, a number of things need to be kept in mind to ensure the best treatment for Epilepsy. Some of the medication adjustments needed are as follows.
- A major part of providing the best epilepsy treatment in India is to make sure that all anti-epileptic medications given are appropriate for the type of epilepsy.
- Next, the best epilepsy treatment in India is only possible by making sure that the anti-epileptic medications don’t interact with one another. For example, if someone is taking both phenobarbitone and lamotrigine, the lamotrigine becomes ineffective.
- And finally, the best epilepsy treatment in India includes making sure that the anti-epileptic medications don’t interact with other medications that the patient is taking.
4. Video EEG in Mumbai
In certain cases, the patient may be admitted and continuous video EEG monitoring (also called Epilepsy monitoring) is done.
Long term Video-EEG monitoring is done for the following reasons:
- When the diagnosis of Epilepsy is in doubt.
- When the type of Epilepsy is not clear.
- When the anti-epileptic medications need to be changed rapidly.
- When the EEG background needs to be studied closely, especially during sleep.
- When the patient is not responding to medications – to plan Epilepsy surgery.
How long does the Epilepsy Monitoring Unit admission or video EEG monitoring in Mumbai, India take?
Ideally, all types of events that you are having should be recorded. Ideally, we try to record 2-3 events of each type.
The duration of monitoring depends on seizure frequency. Here is an approximate guide:
| Seizure Frequency | Duration of stay |
|---|---|
| Daily | 1 – 3 days |
| 3 to 6 days in a week | 3 – 5 days |
| 2 to 3 days in a week | 5 – 7 days |
| 1 week or less | Variable |
3. Epilepsy surgery in Mumbai, India
Epilepsy surgery for Epilepsy treatment in India is done only in cases which don’t respond to all these efforts.
If seizures keep happening despite taking adequate doses of 2 or more appropriate anti-epileptic medications, you should consider Epilepsy Surgery.
As part of providing the best Epilepsy treatment in India, Dr. Siddharth Kharkar provides evaluation for Epilepsy surgery in all clinics. But he provides Epilepsy surgery in India only at Nanavati Hospital in Mumbai.
The process of Epilepsy surgery including Epilepsy surgery cost in India is described in detail in another article here: [Epilepsy surgery in Mumbai, India – How is it done?]
Briefly, all patients who get Epilepsy surgery need the following tests:
1. MRI Brain at 3 Tesla – Epilepsy Protocol
2. Video EEG monitoring – to capture at least 2-3 seizures of each type. This may take between 2-7 days depending on your seizure frequency.
- f-MRI (functional MRI) – This tells us the location of the language areas in the brain. Damage to any of these areas is avoided during surgery.
- Neuropsychological testing – to understand the thinking and memory functions of the patient’s brain
- Psychiatric assessment – To make sure that the patient’s emotional needs are addressed
In addition, depending on the case, the following things may be needed for the best epilepsy surgery:
- PET scan
- SPECT scan
- MEG scan
- Stereo-EEG or intracranial electrode implantation
We are able to provide evaluation and all types Epilepsy surgery in Mumbai including simple temporal lobectomy (Temporal lobe epilepsy surgery), disconnection surgeries, corpus callosotomies, non-lesional respective surgeries and neuromodulation including Vagus Nerve stimulation (VNS) in Mumbai, India.
4. Vagal Nerve Stimulation (VNS) for Epilepsy treatment in India
A Vagus nerve stimulator is a special device that can be used when resective surgery cannot be done.
Sometimes, the seizure-producing area of the brain cannot be removed by surgery. This happens in the following cases:
- The seizure-producing area is too big
- There are many seizure-producing areas, on both sides of the brain.
- The seizure-producing area is too close to a critical part of the brain.
- The seizure-producing area is not clear, in spite of multiple investigations.
- For Epilepsy syndromes like Lennox-Gastaut syndrome, it can be one of the important components of the best treatment for Epilepsy.
In such cases, Vagus Nerve Stimulation (VNS) surgery in India is provided.
VNS is a special device which sits under the skin in the chest. A small wire from this device is connected to a nerve in the neck.
This is a simple surgery, however, the efficacy is less than removing the diseased part of the brain (resective surgery). VNS implantation and programming are provided at NeuroPlus Clinic in Mumbai.
5. Summary of Best Epilepsy treatment in India services
| Service / Procedure | Available |
|---|---|
| Routine EEG recording | Yes |
| Video EEG monitoring in Mumbai, India / Epilepsy Monitoring admission | Yes |
| Epilepsy specialist in Mumbai, India evaluation and Medicine titration | Yes |
| Evaluation for Epilepsy surgery in Mumbai | Yes |
| 3 Tesla MRI for identifying very small problems in the brain | Yes |
| Positron Emission Tomography (PET) scan to identify abnormal areas of the brain producing seizures | Yes |
| Single-photon emission computed tomography (SPECT) scan to identify the areas of the brain producing seizures | Yes |
| Functional MRI (fMRI) to identify the parts of the brain that produce language, hand movement etc and therefore should be preserved during epilepsy surgery | Yes |
| Stereo EEG (sEEG) for identification of the epilepsy focus – needed in about 10–20% cases | Yes |
| Subdural grid monitoring for identification of Epilepsy focus – usually not needed | Yes |
| Resective epilepsy surgery for termination of Epilepsy including the following surgeries: | Yes |
| – Right and Left temporal lobectomy in Mumbai | Yes |
| – Removal of Focal cortical dysplasia (FCD) | Yes |
| – Removal of other lesions which can cause Epilepsy such as Cavernomas and low grade tumors (e.g. DNETs) | Yes |
| Vagus Nerve Stimulation (VNS) surgery in India for Epilepsy | Yes |
Deep Brain Stimulation Programming in Mumbai
DBS programming for Parkinson’s disease, Essential Tremor, and Dystonia.
Dr. Siddharth Deepak Kharkar
MBBS, MD (Neurology, USA), MHS
Neurologist in Mumbai
Best Epilepsy specialist in Mumbai, India
Parkinson’s Disease Specialist in Mumbai
Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine.
Dr. Kharkar is a USA board certified (American Board of Psychiatry & Neurology certified) Neurologist. He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.
Dr. Siddharth Kharkar was part of the Epilepsy faculty at the University of Alabama in Birmingham, USA.
Currently, Dr. Siddharth Kharkar is a General Neurologist, Epilepsy specialist (Seizure specialist) & Parkinson’s specialist practicing in Mumbai, India.
He is also one of the current International coordinators of the Non-Motor Parkinson’s disease study Group (International Parkinson’s and Movement Disorder Society).
| Dr. Siddharth Kharkar |
|---|
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| Contact |
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Neuro+ Epilepsy & Parkinson’s Clinic – Dr. KharkarDr Balabhai Nanavati hospital, near LIC, LIC Colony, Vile Parle, Maharashtra 400056
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Experience
MBBS – King Edward Memorial Hospital, Mumbai, India
MHS – Johns Hopkins University, Baltimore, USA
Research Coordinator, Department of Neurosurgery, Johns Hopkins University, Baltimore, USA
Residency in Internal Medicine – Washington Hospital Center, Washington DC, USA
Residency in Neurology – Drexel University, Philadelphia, USA
Fellowship in Epilepsy – University of California at San Francisco (UCSF), USA
Clinical attachment in Movement disorders, Kings College, London, UK
Assistant Professor of Epilepsy, University of Alabama at Birmingham (UAB), Birmingham, USA
Consultant Neurologist, Wockhardt Group of Hospitals, Mumbai, India
Consultant Neurologist, Nanavati Hospital, Mumbai India
Honors and Awards
2020 - "Top Neurologists in Mumbai" - Outlook India Magazine
2020 - "Best Neurologists in Mumbai" - India Today Magazine
2021 - "Best Neurologists in Mumbai" - India Today Magazine
2011 – Best Resident Research project award - Drexel University, USA
2010 – Selected for the national “Neurology Residents Scholar Program” for epilepsy training, Drexel University, USA
2008 – Humanitarian Resident of the Year award, Drexel University, USA
Member of:
Indian Academy of Neurology
Maharashtra Association of Neurology
American Academy of Neurology
American Epilepsy Society
International Parkinson's & Movement Disorders Society
Invited Reviewer
- Journal of Parkinson’s disease
- Epilepsy Research
- Annals of Neurology
- Neurosurgery
- Journal of Neurosurgery
Selected publications
- Kharkar, S., Ellenbogen, J. R., Samuel, M., Rizos, A., Silverdale, M., Chaudhuri, K. R., & Ashkan, K. Changes in Parkinson’s disease sleep symptoms and daytime somnolence after bilateral subthalamic deep brain stimulation in Parkinson’s disease. NPJ Parkinson’s Disease, 2018, 4, 16
- Kharkar S, Knowlton RD: Magnetoencephalography in the presurgical evaluation of epilepsy. Epilepsy and Behavior. 2014 Dec 30. pii: S1525-5050(14)00648-9
- Kharkar S, Rochestie D, Pillai J, Haneef Z: Anti-epileptic Drug Prescription Patterns and Socio-economic status– Seizure. 2014 Apr;23(4):290-4
Show complete list of publications (30+)
A. Manuscripts:
- Kharkar S, Taksande A: Cryptic Cardiac Arrythmia Uncloaked by Anti-epileptic therapy: World Congress of Neurology, Dubai 2019
- Kharkar S, Taksande A, Dhamne M: Prinzmetal’s Angina in Myotonic Dystrophy: World Congress of Neurology, Dubai 2019
- Kharkar, S., Ellenbogen, J. R., Samuel, M., Rizos, A., Silverdale, M., Chaudhuri, K. R., & Ashkan, K. Changes in Parkinson’s disease sleep symptoms and daytime somnolence after bilateral subthalamic deep brain stimulation in Parkinson’s disease. NPJ Parkinson’s Disease, 2018, 4, 16
- Kharkar S, Knowlton RD: Magnetoencephalography in the presurgical evaluation of epilepsy. Epilepsy and Behavior. 2014 Dec 30. pii: S1525-5050(14)00648-9
- Kharkar S, Rochestie D, Pillai J, Haneef Z: Anti-epileptic Drug Prescription Patterns and Socio-economic status– Seizure. 2014 Apr;23(4):290-4
- Kharkar S, Venkatesh YS, Grothusen JR, Rojas L, Schwartzman RJ. Skin biopsy in complex regional pain syndrome: case series and literature review. Pain Physician. 2012 May-Jun;15(3):255-66.
- Kharkar S, Ambady P, Yedatore YV, Schwartzman RJ: Intramuscular Botulinum Toxin A (BtxA) in Complex Regional Pain Syndrome: Case series and Literature Review – Pain Physician. 2011 May;14(3):311-6.
- Kharkar S; Hernandez R; Batra S, Metellus P, Hillis A; Williams MA; Rigamonti D. Cognitive Impairment in patients with Idiopathic Pseudotumor Cerebri Syndrome – Behavioral neurology, 2011 Jan 1;24(2):143-8.
- Metellus P, Batra S, Kharkar S, Kapoor S, Weiss S, Kleinberg L, Rigamonti D. Fractionated conformal radiotherapy in the management of cavernous sinus Meningiomas: long-term functional outcome and Tumor control at a single institution. Int J Radiat Oncol Biol Phys, 2010 Nov 1; 78(3):836-43.
- Kapoor S, Batra S, Carson K, Shuck J, Kharkar S, Gandhi R, Jackson J, Wemmer J, Terezakis S, Shokek O, Kleinberg L, Rigamonti D: Long-Term Outcomes of Vestibular Schwannomas Treated With Fractionated Stereotactic Radiotherapy: An Institutional Experience. Int J Radiat Oncol Biol Phys, 2010 Sep 29 (epub ahead of print).
- Metellus P, Kapoor S, Kharkar S, Batra S, Jackson JF, Kleinberg L, Miller NR, Rigamonti D. Fractionated Conformal Radiotherapy for Management of Optic Nerve Sheath Meningiomas: Long-Term Outcomes of Tumor Control and Visual Function at a Single Institution. Int J Radiat Oncol Biol Phys, 2010 Apr 16 (epub ahead of print).
- Metellus P, Hsu W, Kharkar S, Kapoor S, Rigamonti D. Percutaneous Placement of Ventriculoatrial Shunt under Ultrasonography Guidance: A Retrospective Study at a Single Institution. Technical note. J Neurosurg 2009 May; 110(5):867-70.
- Kharkar S, Shuck J, Wang P, Rigamonti D, Williams MA: Radionuclide Shunt Patency Study for Evaluation of Suspected Ventriculo-Peritoneal Shunt Malfunction in Adults with Normal Pressure Hydrocephalus. Neurosurgery 2009 May; 64(5):909-16.
- Williams MA, Thomas G, DeLateur B, Imteyaz H, Rose G, Shore W, Kharkar S, Rigamonti D: Objective Assessment of Gait in Normal Pressure Hydrocephalus. Am J Phys Med Rehabil. 2008 Jan;87(1):39-45.
- Kharkar S, Shuck J, Conway J, Rigamonti D: The natural history of conservatively managed symptomatic intramedullary spinal cord cavernomas. Neurosurgery, 2007 May;60(5):865-72
- Goodwin C, Kharkar S, Wang P, Pujari S, Rigamonti D, Williams MA: Evaluation and treatment of patients with suspected normal pressure hydrocephalus on long term warfarin anticoagulation therapy. Neurosurgery, 2007 Mar;60(3):497-501
- Characteristics and Reversibility of Dementia in Normal Pressure Hydrocephalus: Chaudhry P, Kharkar S, Heidler-Gary J, Hillis AE, Newhart M, Kleinman JT, Davis C, Rigamonti D, Wang P, Irani D, Williams MA, Behav Neurology, 2007;18(3):149-58.
- Metellus P, Kharkar S, Weiss S, Daniele R: Cavernous Sinus Meningiomas: Treatment Strategy in the Stereotactic Irradiation Era: A Review. Neurosurgery Quarterly, 2007 Sep 17:3, 226-234.
- Pillion JP, Kharkar S, Mahmood A, Moser H, Shimizu H: Auditory brainstem response findings and peripheral auditory sensitivity in adrenoleukodystrophy. J Neurol Sci 2006 Sep 25;247(2):130-7.
- Dubey P, Raymond GV, Moser AB, Kharkar S, Bezman L, Moser HW: Adrenal insufficiency in asymptomatic adrenoleukodystrophy patients identified by very long-chain fatty acid screening. J Pediatr 2005 Apr; 146(4):528-32.
B. Book Chapters:
- Metellus P, Kharkar S, Lin D, Rigamonti D: Cerebral Cavernous Malformations in “Stroke Syndromes” Editor: Louis Caplan, Cambridge University Press.
C. Abstracts:
- Rochestie D, Kharkar S, Pillai J, Haneef Z: Anti-epileptic Drug Prescription Patterns and Socio-economic status– American Academy of Neurology, 2011
- Rigamonti D, Batra S, Kapoor S, Carson K, Shuck J, Kharkar S, Gandhi R, Jackson J, Wemmer J, Terazakis S, Shokek O, Kleinberg L, Marchionni L: A call for better definition of success and failure in radiosurgery for Vestibular Schwannomas – International Stereotactic Radiosurgery Society, 2011
- Solomon D, Kharkar S, Rigamonti D, Williams MA Utility of the Tinetti as a Standardized Gait Assessment tool in Normal Pressure Hydrocephalus. – American Academy of Neurology, 2009
- Fox JL, Kleinberg L, Kharkar S, Clatterbuck RE, Wang P, Wharam M: Radiosurgery alone for solitary and multiple brain metastasis. Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings Part I. Vol 24, No. 18S (June 20 Supplement ) , 2006: 1541
- Shuck J, Kharkar S, Rigamonti D: Lesion location affects age of seizure onset in patients with intracranial cavernous malformations – 58th Annual meeting of the American Academy of Neurological surgeons, Apr 2006.
- Medina M, Kharkar S, Heidler J, Williams MA: Cognitive profile in the syndrome of hydrocephalus in young and middle-aged adults. – 58th Annual meeting of the American Academy of Neurology, Apr 2006.
- Goodwin C, Kharkar S, Pujari S, Wang P, Williams M, Rigamonti D: Evaluation and treatment of patients on anticoagulation therapy for normal pressure hydrocephalus. Poster presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Kharkar S, Hernandez R, Shuck J, Rigamonti D, Williams M: Comparison of cerebrovascular risk factors in patients with suspected normal pressure hydrocephalus and population controls. Poster presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Kharkar S, Huang H, Mori S, Williams M, Rigamonti D: Diffusion-tensor MRI before and after CSF drainage trial in normal pressure hydrocephalus. Platform presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Pujari S, Kharkar S, Wang P, Rigamonti D, Williams M: Very long-term clinical course in normal pressure hydrocephalus. Poster presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Kharkar S, Pujari S, Williams M: Comparison of patients’ perception of cognitive impairment and performance on cognitive tests before and after shunt surgery for normal pressure hydrocephalus. Poster presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Wang P, Kharkar S, Rigamonti D, Williams M: Cognitive impairment in pseudotumor cerebri. Platform presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Williams M, Kharkar S, Wang P, Rigamonti D: Reliability of radionuclide shunt patency study for evaluation of suspected Ventriculo-peritoneal shunt malfunction in adults with normal pressure hydrocephalus. Poster presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
- Re-submitted: Medina M, Kharkar S, Heidler J, Williams M: Cognitive profile in the syndrome of hydrocephalus in young and middle-aged adults. Platform presentation, The International Congress on Hydrocephalus, Göteborg, Sweden, Sep 2006.
D. Acknowledgements in published manuscripts:
- Zhang J, Williams MA, Rigamonti D: Genetics of human hydrocephalus. J Neuro, (10):125566, 2006.
- Williams MA, Sharkey P, VanDoren D, Thomas G, Rigamonti D: Influence of Shunt Surgery on Health Care Expenditures of Elderly Fee-for-Service Medicare Beneficiaries with Hydrocephalus. J. Neurosurg, 107(1):21-8., 2007.
E. Publications comments / Letters to Editor:
- Kharkar S., Rigamonti D.: Comment in Stereotactic Ventriculo-Peritoneal Shunting for Idiopathic Intracranial Hypertension: Neurosurgery. 60 (6):1039-1044, Jun 2007.
- Kharkar S., Conway J, Rigamonti D.: Comment in – Acute presentation of Spinal Epidural Cavernous Malformations Neurosurgery. 60(3):E575-E576, Mar 2007.
- Kharkar S, Conway J, Rigamonti D: Comment in – Lethal recurrent haemorrhages of a brainstem cavernoma – Comment in: Neurosurgical review 30(3) 259-262, Jul 2007.
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor’s permission.