Referral trends for temporal lobe epilepsy surgery between 2000 and 2014 in India

We conducted a retrospective study examining the trends in referral to a tertiary epilepsy surgery center in India over 2 decades.

Data of patients who underwent long-term video electro encephalography monitoring for presurgical evaluation were retrospectively analyzed. Patients aged >16 years and diagnosed to have drug-resistant temporal lobe epilepsy (TLE) were included. They were divided into 3 groups comprising 5-year periods each during which they underwent presurgical evaluation, group 1: year 2000-2004; group 2: year 2005-2009; and group 3: year 2010-2014. Referral data with particular reference to duration of epilepsy before referral, age at onset of seizures, and number of antiepileptic drugs tried before referral were analyzed.

A total of 1362 patients fulfilled the inclusion criteria. There were 385 referrals in group 1, 488 in group 2, and 489 in group 3. The mean duration of epilepsy before referral was 18.10 ± 9.44 years; there was no change in the duration of epilepsy before referral (p = 0.638). A significant increase in the age at onset of seizures and age at presurgical evaluation was noted over time.

There is evidence for delayed referral of patients with refractory TLE to a surgical epilepsy center in this study. Renewed efforts to confront challenges beholding epilepsy surgery and steps to ensure timely referral are desirable.