METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.

RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.