Epilepsy Treatment in Mumbai: Diagnosis, Medication, and Surgical Options

What are the treatment options for epilepsy in Mumbai?

Epilepsy is a neurological condition characterised by recurrent, unprovoked seizures. Treatment options include anti-seizure medications, dietary therapy, nerve stimulation, and surgery. Most people with epilepsy can achieve significant seizure control with the right combination of these approaches. S.L. Raheja Hospital in Mumbai provides neurology services covering the full spectrum of epilepsy care, from initial diagnosis through to advanced management.

Epilepsy affects the brain — specifically the electrical activity that coordinates nerve cell communication. A structured care pathway at a specialist neurology centre helps identify the seizure type, underlying cause, and the most appropriate treatment plan.

What tests are done to diagnose epilepsy?

Accurate diagnosis requires ruling out other causes of seizures and identifying the epilepsy syndrome. The following investigations are typically used:

A neurologist will review the results alongside a detailed seizure history — including frequency, duration, triggers, and any aura — before confirming an epilepsy diagnosis and classifying the seizure type.

What medications are used to treat epilepsy?

Anti-seizure medications (ASMs) are the first-line treatment for epilepsy. The choice of medication depends on the seizure type, epilepsy syndrome, patient age, and other medical conditions. Approximately 60–70% of people with epilepsy achieve seizure control with medication alone.

• Sodium valproate — broad-spectrum; used for generalised and focal seizures
• Levetiracetam — well tolerated; suitable for multiple seizure types
• Lamotrigine — commonly used for focal and generalised seizures; preferred in women of childbearing age in many cases
• Carbamazepine / Oxcarbazepine — primarily for focal (partial) seizures
• Clobazam / Clonazepam — adjunctive therapy or for specific seizure types
• Newer agents (e.g. lacosamide, perampanel) — used when initial medications do not provide adequate control

Medication is usually started at a low dose and titrated upward until seizures are controlled or side effects limit further increases. Regular follow-up and blood-level monitoring may be required for certain medications.

When is surgery recommended for epilepsy?

Epilepsy surgery is considered when seizures continue despite adequate trials of two or more appropriately chosen anti-seizure medications — a condition termed drug-resistant epilepsy. Surgery aims to remove or disconnect the brain region responsible for generating seizures.

Pre-surgical evaluation typically includes video-EEG monitoring, high-resolution MRI, and functional mapping to ensure the target area can be safely treated without affecting critical functions such as speech or movement.

• Resective surgery — removal of the seizure focus (e.g. temporal lobectomy for mesial temporal lobe epilepsy)
• Lesionectomy — removal of a discrete structural lesion such as a cavernoma or cortical dysplasia
• Corpus callosotomy — division of the fibres connecting the two brain hemispheres; used to reduce drop attacks
• Hemispherectomy / Hemispherotomy — for severe unilateral epilepsy in selected cases
• Vagus nerve stimulation (VNS) — an implanted device that sends regular electrical impulses to the brain via the vagus nerve; suitable when resection is not possible
• Responsive neurostimulation (RNS) — detects abnormal electrical activity and delivers targeted stimulation to abort seizures

Surgery is not appropriate for every patient. A multidisciplinary team — including neurologists, neurosurgeons, neuroradiologists, and neuropsychologists — reviews each case individually before recommending an operative approach.

What non-surgical, non-medication therapies are available for epilepsy?

For patients who do not achieve full seizure control with medication alone and are not surgical candidates, several adjunctive therapies may be considered:

• Ketogenic diet — a high-fat, low-carbohydrate diet that alters brain metabolism and can reduce seizure frequency, particularly in children with drug-resistant epilepsy
• Modified Atkins diet — a less restrictive dietary approach with similar metabolic principles
• Vagus nerve stimulation (VNS) — implanted device; reduces seizure frequency over time in a proportion of patients
• Deep brain stimulation (DBS) — electrical stimulation of specific brain targets; used in selected refractory cases

Lifestyle measures — consistent sleep, avoidance of known triggers (such as alcohol, flashing lights in photosensitive epilepsy, and missed medication doses), and stress management — complement all treatment strategies and should be discussed with the treating neurologist.

For patients managing related blood disorders or requiring haematological support alongside neurological care, S.L. Raheja Hospital's haematology services are available within the same facility.

When should you see a neurologist for seizures or epilepsy?

Seek urgent neurological evaluation in any of the following situations:

1. A first-ever seizure, even if the person recovered fully
2. A seizure lasting more than 5 minutes, or two seizures occurring within 24 hours without full recovery between them
3. A seizure occurring in water, at height, or while operating machinery — regardless of duration
4. Seizures that continue despite taking prescribed anti-seizure medication
5. A change in seizure pattern — increased frequency, new seizure type, or prolonged post-ictal confusion
6. A seizure in a person with a known brain tumour, stroke history, or head injury
7. Seizures in a pregnant woman

Routine follow-up with a neurologist is also recommended at least once a year for patients whose epilepsy is well controlled, to review medication, driving restrictions, and any lifestyle changes.

How does S.L. Raheja Hospital in Mumbai support epilepsy care?

S.L. Raheja Hospital, located at Mahim West, Mumbai, provides neurology services as part of a multi-speciality clinical environment. Patients with epilepsy benefit from access to diagnostic facilities including EEG and neuroimaging, a neurology team for medication management, and coordination with neurosurgery for surgical evaluation where indicated.

The hospital's integrated structure means that patients requiring input from other specialities — such as endocrinology for metabolic seizure triggers, or medical oncology when epilepsy is associated with a brain tumour — can access those services within the same facility. Patients with complex haematological needs alongside neurological conditions can also be referred internally to the bone marrow transplant and haematology teams.

To discuss your epilepsy diagnosis or treatment plan with the neurology team at S.L. Raheja Hospital, use the booking form on this page or contact the hospital directly at info@rahejahospital.com.