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• To establish the diagnosis of epileptic seizure
• Define the kind of epilepsy
• Define the area of brain responsible for the seizures
• Evaluate for any abnormal area on special MRI
• Select ideal surgical candidates with very good correlation
• Ensure that the surgery will not result in disabling neuro-psychological deficits, by carrying this out at a dedicated Epilepsy Centre.

Carefully selected patients with intractable epilepsy can have a gratifying outcome in majority of cases. The 2 key points that enable proper selection of cases are:

• Concordant demonstration of Epileptogenic zone on all the specialized investigations: 3T MRI, PET/SPECT scan, videoEEG, Neuropsychological assessment and clinical evaluation. This means all the tests should point to fits coming from same area of the brain.
  
  
• Can the area of origin of fits be operated safely without producing deficit. This has to be judged by a surgeon experienced with such procedures.

Once the above two conditions are met, the patient can be further counselled and likely outcome explained keeping in mind the specific situation. For example, surgery for seizure focus in temporal lobe of the brain has a better outcome than other areas. Similarly, cases wherein MRI shows abnormal area have greater chances of success than those in which MRI is completely normal.