{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:29:30Z","timestamp":1788370170545,"version":"build-2803163510"},"reference-count":34,"publisher":"Scientific Scholar","content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Objectives:<\/jats:title>\n<jats:p>The objectives of this study were to share our initial experience with epilepsy surgery and provide an overview on the surgical treatments of epilepsies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Materials and Methods:<\/jats:title>\n<jats:p>This was a retrospective analysis of the demographics and clinical and investigative features of patients who underwent epilepsy surgery between January 2016 and August 2021. Postoperative seizure outcome was categorized according to modified Engel\u2019s classification, and the minimum period of follow-up was 1 year.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results:<\/jats:title>\n<jats:p>The study group included 30 patients with an age ranging from 6 years to 45 years (mean: 22.28 years, median: 20 years) and a male: female ratio of 20:10. The epilepsy duration before surgery ranged from 3 years to 32 years (median: 7 years). Majority of our patients underwent resective surgeries (28\/30 = 93.3%), and disconnection procedures were done in two patients. This included one functional hemispherotomy and one posterior quadrantic disconnection. Temporal lobe resective surgery was the most common procedure (16\/30 = 53.3%), followed by eight frontal lobe and two parietal lobe surgeries. Among resective surgeries, majority were lesional surgeries and the pathologies included mesial temporal sclerosis (4), dysembryoplastic neuroepithelial tumor (8), ganglioglioma (6), cavernoma (4), focal cortical dysplasia (2), gliosis (1), and one case of hypothalamic hamartoma. Intraoperative electrocorticography was used in all cases for optimizing surgical resection\/disconnection. Nearly two-thirds of our patients (66.6%) had an Engel\u2019s Class I outcome, five patients had Engel\u2019s Class II outcome, three patients had Class III outcome, and one patient did not have any worthwhile improvement. Temporal lobe surgery patients had a better seizure outcome compared to extratemporal surgeries (84% vs. 74%). Overall, complications were minimal and short lasting, and comprised meningitis in three patients (5.6%) and transient worsening of hemiparesis following hemispherotomy in two patients. There was no mortality or long-lasting major morbidity in our patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>In carefully selected patients with drug-resistant epilepsy, surgery offers an excellent chance of becoming seizure-free with significant improvement in overall quality of life. Majority of the common epilepsy surgery procedures can be performed through a multidisciplinary approach even in centers with limited resources.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/jnrp_116_2023","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T10:47:51Z","timestamp":1686912471000},"page":"488-494","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical treatment of epilepsy - Initial experience from a comprehensive epilepsy program in coastal South India"],"prefix":"10.25259","volume":"14","author":[{"given":"Nisha","family":"Shenoy","sequence":"first","affiliation":[{"name":"Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhakrishnan","family":"Kurupath","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"10.25259\/JNRP_116_2023\/ref-1","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJM200108023450501","article-title":"A randomized, controlled trial of surgery for temporal-lobe epilepsy","volume":"345","author":"Wiebe","year":"2001","journal-title":"N Engl J Med"},{"key":"10.25259\/JNRP_116_2023\/ref-2","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1056\/NEJM199603073341008","article-title":"Surgery for seizures","volume":"334","author":"Engel","year":"1996","journal-title":"N Engl J Med"},{"key":"10.25259\/JNRP_116_2023\/ref-3","first-page":"25","article-title":"Surgical treatment of medical refractory epilepsy","volume":"82","author":"Radhakrishnan","year":"2002","journal-title":"Curr Sci"},{"key":"10.25259\/JNRP_116_2023\/ref-4","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1038\/nrneurol.2009.53","article-title":"Challenges in the management of epilepsy in resource-poor countries","volume":"5","author":"Radhakrishnan","year":"2009","journal-title":"Nat Rev Neurol"},{"key":"10.25259\/JNRP_116_2023\/ref-5","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.seizure.2019.05.007","article-title":"Establishment of low cost epilepsy surgery centres in resource poor setting","volume":"69","author":"Jukkarwala","year":"2019","journal-title":"Seizure"},{"key":"10.25259\/JNRP_116_2023\/ref-6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1684\/epd.2014.0720","article-title":"Concept of epilepsy surgery and presurgical evaluation","volume":"17","author":"Rathore","year":"2015","journal-title":"Epileptic Disord"},{"key":"10.25259\/JNRP_116_2023\/ref-7","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","article-title":"Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies","volume":"51","author":"Kwan","year":"2010","journal-title":"Epilepsia"},{"key":"10.25259\/JNRP_116_2023\/ref-8","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1093\/brain\/awh449","article-title":"Long-term seizure outcomes following epilepsy surgery: A systematic review and meta-analysis","volume":"128","author":"Tellez-Zenteno","year":"2005","journal-title":"Brain"},{"key":"10.25259\/JNRP_116_2023\/ref-9","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1212\/WNL.51.5.1243","article-title":"Etiology as a risk factor for medically refractory epilepsy: A case for early surgical intervention","volume":"5","author":"Engel","year":"1998","journal-title":"Neurology"},{"key":"10.25259\/JNRP_116_2023\/ref-10","doi-asserted-by":"publisher","first-page":"e208","DOI":"10.1212\/WNL.0000000000005820","article-title":"Outcome after seizure recurrence on antiepileptic drug withdrawal following temporal lobectomy","volume":"91","author":"Rathore","year":"2018","journal-title":"Neurology"},{"key":"10.25259\/JNRP_116_2023\/ref-11","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1212\/01.WNL.0000055086.35806.2D","article-title":"Practice parameter: Temporal lobe and localized neocortical resections for epilepsy","volume":"60","author":"Engel","year":"2003","journal-title":"Neurology"},{"key":"10.25259\/JNRP_116_2023\/ref-12","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1053\/seiz.2000.0409","article-title":"An estimate of the prevalence of psychogenic non-epileptic seizures","volume":"9","author":"Benbadis","year":"2000","journal-title":"Seizure"},{"key":"10.25259\/JNRP_116_2023\/ref-13","first-page":"40","article-title":"Multimodal approaches in the evaluation of patients for epilepsy surgery","volume":"50","author":"Engel","year":"1999","journal-title":"Clin Neurophysiol"},{"key":"10.25259\/JNRP_116_2023\/ref-14","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1080\/1086508X.2001.11079336","article-title":"The role of scalp EEG in the presurgical evaluation of patients with medically refractory temporal lobe epilepsy","volume":"41","author":"Sylaja","year":"2001","journal-title":"Am J Electroneurodiagn Technol"},{"key":"10.25259\/JNRP_116_2023\/ref-15","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1136\/jnnp.63.3.327","article-title":"Noninvasive investigations successfully select patients for temporal lobe surgery","volume":"63","author":"Kilpatrick","year":"1997","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/JNRP_116_2023\/ref-16","doi-asserted-by":"publisher","first-page":"375","DOI":"10.2176\/nmc.ra.2017-0008","article-title":"Stereoelectroencephalography: Indication and efficacy","volume":"15","author":"Iida","year":"2017","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/JNRP_116_2023\/ref-17","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.neurol.2015.01.561","article-title":"Surgical treatment for mesial temporal lobe epilepsy associated with hippocampal sclerosis","volume":"171","author":"Mathon","year":"2015","journal-title":"Rev Neurol (Paris)"},{"key":"10.25259\/JNRP_116_2023\/ref-18","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.seizure.2018.11.007","article-title":"Neurosurgical approaches to pediatric epilepsy: Indications, techniques, and outcomes of common surgical procedures","volume":"77","author":"Dallas","year":"2020","journal-title":"Seizure"},{"key":"10.25259\/JNRP_116_2023\/ref-19","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1212\/WNL.51.2.465","article-title":"Predictors of outcome of anterior temporal lobectomy for intractable epilepsy: A multivariate study","volume":"51","author":"Radhakrishnan","year":"1998","journal-title":"Neurology"},{"key":"10.25259\/JNRP_116_2023\/ref-20","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1111\/j.0013-9580.2004.48503.x","article-title":"Seizure outcome after anterior temporal lobectomy and its predictors in patients with apparent temporal lobe epilepsy and normal MRI","volume":"45","author":"Sylaja","year":"2004","journal-title":"Epilepsia"},{"key":"10.25259\/JNRP_116_2023\/ref-21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.3390\/bs11030030","article-title":"Surgical outcome in extratemporal epilepsies based on multimodal pre-surgical evaluation and sequential intraoperative electrocorticography","volume":"11","author":"Chac\u00f3n","year":"2021","journal-title":"Behav Sci (Basel)"},{"key":"10.25259\/JNRP_116_2023\/ref-22","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s11940-004-0017-4","article-title":"Surgical treatment for extratemporal epilepsy","volume":"6","author":"Cascino","year":"2004","journal-title":"Curr Treat Options Neurol"},{"key":"10.25259\/JNRP_116_2023\/ref-23","doi-asserted-by":"publisher","first-page":"336","DOI":"10.3340\/jkns.2019.0031","article-title":"From resection to disconnection for seizure control in pediatric epilepsy children","volume":"62","author":"Hwang","year":"2019","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/JNRP_116_2023\/ref-24","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1111\/j.1528-1167.2007.01095.x","article-title":"Posterior quadrantic epilepsy surgery: Technical variants, surgical anatomy, and case series","volume":"48","author":"Daniel","year":"2007","journal-title":"Epilepsia"},{"key":"10.25259\/JNRP_116_2023\/ref-25","doi-asserted-by":"publisher","first-page":"ONS19","DOI":"10.1227\/01.NEU.0000249246.48299.12","article-title":"Vertical parasagittal hemispherotomy: Surgical procedures and clinical long-term outcomes in a population of 83 children","volume":"60","author":"Delalande","year":"2007","journal-title":"Neurosurgery"},{"key":"10.25259\/JNRP_116_2023\/ref-26","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1227\/00006123-199511000-00018","article-title":"Peri-insular hemispherotomy: Surgical principles and anatomy","volume":"37","author":"Villemure","year":"1995","journal-title":"Neurosurgery"},{"key":"10.25259\/JNRP_116_2023\/ref-27","doi-asserted-by":"publisher","first-page":"2017","DOI":"10.1007\/s00701-012-1481-3","article-title":"Pediatric functional hemispherectomy: Outcome in 92 patients","volume":"154","author":"Schramm","year":"2012","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/JNRP_116_2023\/ref-28","first-page":"1074","author":"Andermann","year":"1997","edition":"2nd ed"},{"key":"10.25259\/JNRP_116_2023\/ref-29","doi-asserted-by":"publisher","first-page":"837","DOI":"10.4103\/0028-3886.325379","article-title":"Endoscopic hemispherotomy for nonatrophic rasmussen's encephalopathy","volume":"69","author":"Doddamani","year":"2021","journal-title":"Neurol India"},{"key":"10.25259\/JNRP_116_2023\/ref-30","doi-asserted-by":"publisher","first-page":"294","DOI":"10.3340\/jkns.2017.0101.005","article-title":"Endoscopic treatment of hypothalamic hamartomas","volume":"60","author":"Shim","year":"2017","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/JNRP_116_2023\/ref-31","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.3390\/brainsci11121608","article-title":"Surgical aspects of corpus callosotomy","volume":"11","author":"Uda","year":"2021","journal-title":"Brain Sci"},{"key":"10.25259\/JNRP_116_2023\/ref-32","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1093\/neuros\/nyx311","article-title":"Multiple subpial transections for medically refractory epilepsy: A disaggregated review of patient-level data","volume":"82","author":"Rolston","year":"2018","journal-title":"Neurosurgery"},{"key":"10.25259\/JNRP_116_2023\/ref-33","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s10143-016-0725-8","article-title":"Seizure outcomes in nonresective epilepsy surgery: An update","volume":"40","author":"Englot","year":"2017","journal-title":"Neurosurg Rev"},{"key":"10.25259\/JNRP_116_2023\/ref-34","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.seizure.2016.10.015","article-title":"Long-term outcomes of surgical treatment for epilepsy in adults with regard to seizures, antiepileptic drug treatment and employment","volume":"44","author":"Malmgren","year":"2017","journal-title":"Seizure"}],"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ruralneuropractice.com\/surgical-treatment-of-epilepsy-initial-experience-from-a-comprehensive-epilepsy-program-in-coastal-south-india\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ruralneuropractice.com\/surgical-treatment-of-epilepsy-initial-experience-from-a-comprehensive-epilepsy-program-in-coastal-south-india\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T14:01:06Z","timestamp":1692194466000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/surgical-treatment-of-epilepsy-initial-experience-from-a-comprehensive-epilepsy-program-in-coastal-south-india\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,16]]},"references-count":34,"alternative-id":["10.25259\/JNRP_116_2023"],"URL":"https:\/\/doi.org\/10.25259\/jnrp_116_2023","relation":{},"ISSN":["0976-3155","0976-3147"],"issn-type":[{"value":"0976-3155","type":"electronic"},{"value":"0976-3147","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6,16]]},"article-number":"488"}}