Epilepsy surgery in India – Where, why and costs

1. Why is Epilepsy surgery in India done?

Some people have seizures. These happen because of uncontrolled electricity in the brain.

This condition is called “Epilepsy”.


About 80% patients stop having seizures when they take medications.

But 20% people keep having seizures despite taking 2 or more medications. These patients have “Medically resistant epilepsy”.

80 percent 1

They need Epilepsy surgery to stop their seizures.

2. Is Epilepsy surgery done in India?

Yes. All types of epilepsy surgeries can be done in India.

In the USA epilepsy surgery is very common. Larger hospitals (like UCSF, where I was educated) do about 2-3 epilepsy surgeries per week.

ucsf 1

In India, Epilepsy surgery is less common. This is because:

–     Patients & doctors are not aware of it.

–     Fewer doctors are trained in Epilepsy surgery.

–     Cost

–     Fear of complications

–     But most importantly, many Indians have a sad, hopeless and completely wrong belief that epilepsy is uncontrollable.

3. What are the types of Epilepsy Surgery?

There are many types of Epilepsy surgery.


This is the best Epilepsy surgery.

The bad seizure-producing part of the brain is removed. This stops seizures.

Resective Removal Epilepsy surgery cost in India



In some cases, resective (removal) surgery is difficult. This can happen if the bad part is too large, or is near important brain parts.

In such cases, Vagus Nerve Stimulation (VNS) surgery is done. This is a faster surgery.

VNS Epilepsy surgery cost in India

A small battery is placed in the skin over the chest. A thin wire is attached to a nerve below the neck skin.

The VNS device sends small currents to the brain which prevent seizures.


Other surgeries are done in special situations. For example, corpus callostomy can be done instead of VNS if the patient cannot afford VNS.

Other types of Epilepsy surgery in India

4. What tests Need to be done before Epilepsy surgery?

The routine tests done before every epilepsy surgery are listed below.

Simple evaluation for Epilepsy surgery in India

We try to answer many questions with these tests:

In some patients, we need to do additional tests to answer these questions. In most patients, these tests are not needed.

In very rare cases, the location of the bad part is unclear even after these tests. In such cases, we need to record EEG directly from the brain.

This is done by placing thin stiff wires in the brain. This process is called stereo-EEG.


5. What is Video EEG Monitoring (Epilepsy Monitoring)?

The patient is admitted for continuous EEG monitoring. During this time, we may reduce medications so that the patient has seizures.

epilepsy monitoring unit for seizure surgery in India 1

We try to capture at least 2 seizures of each type.

For example, if the patient has one seizure type where he falls down, and another type where he starts smacking his lips, then we capture 2+2 = 4 seizures.

If you have seizures frequently, epilepsy monitoring may take just 1-2 days. In other people, it may take 7 days or more.

6. What is the success rate of Epilepsy surgery in India?

The success rate of epilepsy surgery is high but not 100%.

The success rate depends on the type of epilepsy, and the type of epilepsy surgery.

For example:

·       The success rate of Resective surgery can be more than 80%.

·       The success rates of other surgeries are lower, but usually quite good.

falls drop attacks

·       After VNS, most patients seizures decrease by 50% or more. Specifically, drop attacks, where patients fall and hurt themselves, are significantly reduced.

The success rate will be discussed with you after the presurgical tests.

7. Will my medications stop after Epilepsy surgery?

The goal of epilepsy surgery is to stop your seizures.

Approximately 50% patients are able to stop their medications after Epilepsy surgery.

However, other patients need to keep taking their medications. Some patients may be able to reduce their medications.

8. What are the possible complications?

Any surgery has some risks of anaesthesia and infection.

In resective surgery, there is a concern that surrounding areas may be damaged. This depends on the exact location of the bad part.

brain areas important for epilepsy

Surgery needs to be done very carefully if the bad part is close to important brain areas (e.g., speech & memory areas).

Thankfully, stopping seizures after resection improves thinking and memory in many people. This is because the healthy parts of the brain work better.

All possible complications will be discussed with you after the presurgical tests.

9. What is the cost of Epilepsy surgery?

Patients need different evaluations and surgeries, so the cost is different for each patient.

Please note that these costs are approximate and change with time.

For example:

If our patient has frequent seizures and requires a simple resection, the total cost is between 4.5 – 5 lakhs. This is the total cost, including all tests.

TestCost in India
MRIRs. 12,000
PET & MRI-PET fusionRs. 15,000
functional MRI (fMRI)Rs. 12,000
Video-EEG monitoring (3 days)Rs. 30,000 x 3

= Rs. 90,000

Psychiatry & Neuropsychological testingRs. 6,000
Total cost of evaluationRs. 1.35 Lakh
Resective surgery with intraoperative ElectrocorticographyRs. 3.5 Lakh
TOTAL COST Rs. 4.95 Lakh


VNS surgery is very expensive. The major part of the expense is the device, which has to be imported.

TestCost in India
VNS procedure cost (cost of placement)Rs. 1.5 Lakh
VNS device cost – DemipulseRs. 8.5 Lakh
VNS device cost – Aspire SRRs. 10.5 Lakh
VNS device cost – Sentiva (newest model)Rs. 14.5 Lakh


10. Should I (or my child) have Epilepsy surgery?

If a person has medically resistant epilepsy, I usually encourage them to have epilepsy surgery, if:

The patient really has medically resistant epilepsy.

1. Patients may be misdiagnosed. For example, people with heart rhythm issues or stress-related seizures may be wrongly diagnosed with epilepsy.

cardiac arrythmias epilepsy misdiagnosis

2. Sometimes, the type of medication or the dose may be incorrect for the type of epilepsy.

3. Sometimes, patients have seizures because they don’t take their medications.

Possible complications are acceptable to the patient.

For example, if someone’s right hand remains very strong but fine motor skills change after surgery, it could significantly affect a painter.

fine work epilepsy surgery

But, if the patient is a manual labourer, it may not matter much.

The patient should understand there is no 100% guarantee. No surgery has a 100% guarantee.

11. What if I decide to continue just with medications?

There is a chance that new epilepsy medications may be discovered in the future. But it is worth understanding the  history of medication resistant epilepsy.

Kwan and brodie epilepsy surgery in india

In 2000, Dr. Kwan and Dr. Brodie conducted an important study. They discovered that if two seizure medications didn’t work, the chances of becoming seizure-free with medications alone was less than 5%.

In the 20+ years since that study, many new seizure medications have been invented. These have fewer side-effects but unfortunately, their efficacy is not very different (see below).

The number of patients who don’t respond to medications remained nearly the same.

12. What about the newest medications?

I was hopeful about a new medication called Perampanel because it acts in a completely different way as compared to other anti-seizure medications.

nmda receptors as targets for drug resistant epilepsy 1

Unfortunately, me and other neurologists have found that it is not very effective in most people with medically resistant epilepsy.

Many of the other “newer” medications like Eslicarbazepine are the same as the older medications (carabamazepine) with only minor differences.

For example, Eslicarbazepine can be taken once daily, whereas carbamazepine needs to be taken twice daily.

13. What are the possible complications of waiting?

I, too, hope for much more effective medications in the future. But our need for treatment is in the present.

waiting for epilepsy surgery

Waiting has drawbacks.

1.    If seizure surgery can make a person seizure free, waiting means wasting productive years of his/her life.

2.    Brain damage is a worry, for patients who have frequent seizures. Waiting in such cases may cause permanent thinking and memory problems.

3.    If patients have many seizures, other parts of the brain may also become abnormal and start producing seizures.

14. Can almost all patients with Epilepsy have a full, normal life?


Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

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.

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ a year ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ a year ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ a year ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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