Table of Contents
Epilepsy Research and Treatment
Volume 2012, Article ID 547382, 6 pages
http://dx.doi.org/10.1155/2012/547382
Research Article

Establishment of a Comprehensive Epilepsy Center in Pakistan: Initial Experiences, Results, and Reflections

1Section of Neurosurgery, Department of Surgery, Aga Khan University, Stadium Road, Karachi, Pakistan
2Department of Neurology, University of Alberta Hospital Edmonton, AB, Canada
3Section of Neurology, Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan
4Department of Neurosurgery, University of Melbourne Parkville, VIC, Australia

Received 16 May 2011; Revised 22 October 2011; Accepted 20 November 2011

Academic Editor: Seyed M. Mirsattari

Copyright © 2012 M. Zubair Tahir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Developing countries, home to 80% of epilepsy patients, do not have comprehensive epilepsy surgery programs. Considering these needs we set up first epilepsy surgery center in Pakistan. Methods. Seventeen teleconferences focused on setting up an epilepsy center at the Aga Khan University (AKU), Karachi, Pakistan were arranged with experts from the University of Alberta Hospital, Alberta, Canada and the University of West Virginia, USA over a two-year period. Subsequently, the experts visited the proposed center to provide hands on training. During this period several interactive teaching sessions, a nationwide workshop, and various public awareness events were organized. Results. Sixteen patients underwent surgery, functional hemispherectomy (HS) was done in six, anterior temporal lobectomy (ATL) in six, and neuronavigation-guided selective amygdalohippocampectomy (SAH) using keyhole technique in four patients. Minimal morbidity was observed in ATL and, SAH groups. All patients in SAH group (100%) had Grade 1 control, while only 5 patients (83%) in ATL group, and 4 patients (66%) in HS group had Grade 1 control according to Engel’s classification, in average followups of 12 months, 24 months and 48 months for SAH, ATL, and HS, respectively. Conclusion. As we share our experience we hope to set a practical example for economically constrained countries that successful epilepsy surgery centers can be managed with limited resources.