We conducted a comprehensive literature search across PubMed, Embase, SciELO, Global Index Medicus, Web of Science, and EBSCO, using terms related to epilepsy, neurosurgical interventions, and LAC. We used the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P). Eligible studies addressed availability and access to neurosurgical procedures, institutional programs, or training opportunities for epilepsy surgery.

From 475 screened records, 49 studies were included, covering only 27% of the 33 LAC countries. These studies revealed significant inequities in access to epilepsy surgery across LAC. Of these, 75.5% were from South America, 12% from the Caribbean and Central America and 10% from Mexico. Lobectomies were the most commonly reported procedure (61% of studies), followed by lesionectomies (26.5%), amygdalohippocampectomies (26.5%) and callosotomies (22%). 14% studies from Argentina, Brazil, Peru, and Mexico, reported on patients who underwent vague nerve stimulation (VNS). Challenges included socio-economic and regional barriers to diagnosis and treatment, limited trained personnel, high surgical costs, and disparities between institutions due to limited technical equipment, especially outside major urban centers.

Access to epilepsy surgery in LAC is hindered by geographic, institutional, and training-related barriers. Expanding specialized surgical centers and improving training opportunities in underserved areas are urgently needed. Regional collaboration could bridge gaps in care and ensure equitable access to epilepsy treatment.