Nine out of 10 epilepsy patients fail to receive surgery in time because of the shortage of neurosurgeons in Korea, a medical association said.

According to the Korean Neurosurgical Association (KNA), about 33 percent of 360,000 epilepsy patients in Korea have refractory epilepsy that drugs cannot control. Among them, about 20,000 patients have severe refractory epilepsy that requires urgent surgery.

However, only around 200 receive epilepsy surgery annually, the KNA said.

The lack of epilepsy surgery stems from insufficient infrastructure. Only six medical institutions -- Samsung Medical Center, the Seoul National University Hospital, Asan Medical Center, the Severance Hospital, Korea University Guro Hospital, and Haeundae Paik Hospital -- can provide epilepsy surgery in Korea. The first five hospitals are all located in Seoul.

Neurosurgeons capable of epilepsy surgery are extremely short, too, and senior neurosurgeons’ retirements have accelerated the shortage, the KNA said.

“Epilepsy surgery needs a collaboration between neurology, pediatric neurology, and neurosurgery departments, as well as professional nurses and video electroencephalogram (EEG) equipment,” the KNA said. “Epilepsy surgery is very demanding, but the reimbursement rate is set low, which makes it difficult for even large university hospitals to perform it.”

University hospitals across the nation are capable of surgery for brain cancer, cerebrovascular malformations, and cerebral hemorrhage. Still, few of them can do epilepsy surgery, the KNA went on to say.

“This is why over 90 percent of epilepsy patients can’t get surgery. Epilepsy is the only disease suffering such shortage of surgeons,” it added.

The KNA noted that the U.S. and Japan have 230 and 50 epilepsy surgery centers, respectively, adding that Korea needs at least 15 to 20.

For patients to get epilepsy surgery anywhere in the country, the government needs to support the establishment of epilepsy surgery centers across the regions just like they did for dementia care centers and regional cardio-cerebrovascular centers, the KNA said.

Citing the severe shortage of skilled neurosurgeons for epilepsy surgery, the KNA said the retirement of the few neurosurgeons should be extended, or they need to be allowed to continue surgery even after retirement.

“The government should prepare measures to allow a few neurosurgeons capable of epilepsy surgery at university hospitals to continue performing surgery even after they turn 65,” the KNA said.