Development of a comprehensive epilepsy surgery programme in Pakistan.

Introduction and Background Though medical treatments suffice in almost all types of epilepsy, Epilepsy Surgery is the standard in the management of intractable seizures. There are some misconceptions that lead to underutilization of this treatment, even in the developed countries.1,2 Some of them include: 1. Only temporal lobe seizures are appropriate for surgery. 2. Seizures arising in the dominant hemisphere are not amenable to surgery. 3. There are excessive cognitive or psychiatric risks involved. 4. Focal abnormalities (like spikes) on routine EEG are a prerequisite. 5. Has a low efficacy and high morbidity. 6. Epilepsy surgery evaluation is very costly.3 7. Patient with interictal psychosis cannot undergo surgery.4 Epilepsy is a relatively common disorder in Pakistan. Based on current data, it is estimated that 1.38 million people suffer from epilepsy in the country. In general population, prevalence of epilepsy is estimated to be 9.99 per thousand.5