Dr. Siddharth Kharkar, MBBS, MD Neurology (USA), MHS

Dr. Siddharth Deepak Kharkar

MBBS, MD (Neurology, USA), MHS

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.

1. 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:

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.

   

3. 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.
4. Neuropsychological testing – to understand the thinking and memory functions of the patient’s brain
5. 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:

1. PET scan

   

2. SPECT scan
3. MEG scan
4. 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