Best Countries for Epilepsy Treatment in the World

Thailand is a premier destination for epilepsy treatment due to its JCI-accredited facilities and specialized neurological expertise. Patients access advanced diagnostics like 3T MRI and long-term EEG monitoring. Shorter waiting times and significantly lower costs for surgical interventions further drive international demand for Thai medical centers.

• Surgical expertise: Procedures include Deep Brain Stimulation (DBS) and Vagus Nerve Stimulation (VNS).
• Advanced diagnostics: Clinics utilize genetic screening, pharmacogenetic studies, and brain MRI with contrast.
• Global recognition: Bumrungrad International Hospital treats over 1,000,000 patients annually from 190 countries.
• Certified specialists: Neurologists like Dr. Somjet Tosamran hold fellowship training specifically in epilepsy subspecialties.

Bookimed Expert Insight: While many choose Bangkok for its 6th-place global healthcare ranking, the real advantage is the concentration of academic expertise. Large centers like Bumrungrad International Hospital feature over 1,300 doctors and 70 departments. This scale allows for multidisciplinary teams that manage complex cases, such as Diffuse Cerebral Dysfunction, which smaller regional clinics cannot handle.

Patient Consensus: Patients emphasize that Thai hospitals offer transparent pricing and logistical support for families. Many note that the medical teams are professional and friendly, providing clear diagnostic results even in very difficult cases.

Neurologists in Thailand are exceptionally qualified. Many hold international certifications from the United States, Europe, or Japan. Leading centers like Bumrungrad International Hospital maintain JCI accreditation. Surgeons often complete fellowships in specialized fields like epilepsy or neurorehabilitation at prestigious university hospitals.

• Professional training: Specialists must complete a three-year residency and pass national licensing exams.
• International credentials: Many doctors hold fellowships from top-tier Western or Asia-Pacific medical institutions.
• Advanced diagnostics: Clinics utilize 3.0T MRI, PET scans, and extended EEG monitoring for accuracy.
• Specialized expertise: Surgeons perform complex cases including Vagus Nerve Stimulation and deep brain stimulation.

Bookimed Expert Insight: Our data shows that Thai neurology centers like Bumrungrad International Hospital serve over 1 million patients annually. Their specialists are incredibly efficient due to this high volume. Dr. Tara Rak-areekul and others frequently win national awards for diagnostic accuracy. This combination of high-tech equipment and massive clinical experience often leads to faster diagnosis than in many Western hospitals.

Patient Consensus: Patients often describe the medical teams in Bangkok as both professional and friendly. They frequently recommend bringing translated records to ensure the smoothest consultation process from day one.

Patients can obtain a second opinion for drug-resistant epilepsy in Thailand through JCI-accredited centers and specialized neurological units. These facilities utilize advanced diagnostics like brain MRI with contrast and EEG wakefulness-to-sleep transition. Expert neurologists provide comprehensive reviews of existing treatment plans and surgical candidacy.

• Diagnostic methods: Clinics offer pharmacogenetic studies and genetic screening to identify medication resistance.
• Surgical options: Specialized centers perform Vagus Nerve Stimulation (VNS) and Deep Brain Stimulation (DBS).
• Expert credentials: Specialists like Dr. Somjet Tosamran hold advanced epilepsy fellowship training from prestigious institutions.
• International standards: Bumrungrad International Hospital is recognized among the World's Best Hospitals by Newsweek.

Bookimed Expert Insight: While many seek second opinions at general hospitals, the data shows a clear advantage in visiting academic-affiliated specialists. Doctors like Dr. Somjet Tosamran and Dr. Tara Rak-areekul, who are affiliated with King Chulalongkorn Memorial Hospital, often win national awards for epilepsy expertise. Their clinical experience in Thailand's first ASEAN-recognized surgical epilepsy center provides a level of diagnostic depth that smaller private clinics cannot match.

Patient Consensus: Patients note that while the medical team is highly professional and friendly, it is helpful to send medical records 1–2 months in advance. Many appreciate the clear communication from English-speaking neurologists when discussing complex diagnoses like cerebral dysfunction.

Primary epilepsy treatments in Germany include advanced anti-seizure medications, specialized resective surgery, and neuromodulation therapies. Neurologists at certified centers like University Hospital Charité Berlin prioritize a start low, go slow approach. They frequently utilize laser ablation and deep brain stimulation for drug-resistant cases.

• Medication protocols: Doctors prioritize monotherapy using Lamotrigine or Levetiracetam to minimize potential side effects.
• Surgical interventions: Experts perform temporal lobectomies or minimally invasive laser interstitial thermal therapy (LITT).
• Neuromodulation devices: Surgeons implant vagus nerve stimulation (VNS) or deep brain stimulation (DBS) systems.
• Advanced diagnostics: Clinics use long-term video-EEG monitoring and genetic screening to identify seizure foci.

Bookimed Expert Insight: Germany holds a global rank of 4 in our medical destination data, reflecting its high success with complex cases. While many focus on surgery, the German aut-idem rule is a major safety advantage. This law ensures pharmacies cannot swap your specific epilepsy medication for a generic brand. This consistency is vital for maintaining seizure control during long-term treatment.

Patient Consensus: Patients note that getting a video-EEG at a specialized center quickly unlocks advanced options like neurostimulation. Many emphasize that doctors are very open to using seizure-tracking app data during consultations.

German university hospitals like Charite Berlin and University Hospital Bonn lead international epilepsy care for adults and children. These centers hold German Society for Epileptology (DGfE) certification. They offer advanced diagnostics like video-EEG monitoring and specialized surgical interventions for refractory cases.

• Charite Berlin: Europe’s largest university hospital treats over 845,000 patients annually with advanced neurology research.
• University Hospital Bonn: A top-tier center with 40 years of experience in complex presurgical evaluations.
• Asklepios Hospital Barmbek: Ranked top for foreign patients by MTQUA, specializing in advanced surgical oncology treatments.
• Schoen Clinic Vogtareuth: A premier Bavarian facility specialized in pediatric neurology and neuro-rehabilitation for children.
• Asklepios Nord Clinic: The largest multidisciplinary facility in Hamburg with dedicated pediatric and neurosurgery departments.

Bookimed Expert Insight: While many seek out Berlin for its reputation, our data shows that specialized centers like Asklepios Nord Clinic in Hamburg provide essential pediatric neurosurgery expertise alongside high patient volumes. Clinics such as Nordwest in Frankfurt am Main stand out by integrating innovative diagnostic tools like 3D ultrasound, which can be crucial for identifying subtle neurological anomalies in complex epilepsy cases.

Patient Consensus: Families note that University Hospital Bonn is world-class for pediatric surgeries, but warn to plan for 2-4 week inpatient stays during video-EEG monitoring. Patients at Helios Hospital Krefeld appreciated receiving gentle therapy options and clear answers to all medical questions from the neurology staff.

German epilepsy centers report long-term seizure-freedom rates between 50% and 80% for surgical patients. Outcomes depend on the epilepsy type and the presence of identifiable brain lesions. Patients with temporal lobe epilepsy achieve the highest success rates, typically ranging from 60% to 70%.

• Success by condition: Temporal lobe surgery results in 60% to 70% long-term seizure freedom.
• Lesional vs non-lesional: Visible MRI lesions lead to significantly better outcomes than non-lesional cases.
• Diagnostic precision: High-volume centers use intracranial EEG and MEG testing to identify seizure foci.
• Reoperation outcomes: Specialized German hospitals report up to 71% success for second surgical procedures.

Bookimed Expert Insight: Data from major academic centers shows that surgeon volume is the most critical success factor. Prof. Dr. Horst Glasner at Meoclinic and Prof. Dr. Marcel Dihne at Solingen offer over 30 to 50 years of neurological expertise. Choosing hospitals with 60,000+ annual patients like Solingen or Charite ensures access to advanced mapping that halves failure risks.

Patient Consensus: Patients emphasize that thorough pre-operative testing like intracranial EEG is worth the 6-month wait. They note that while auras may return years later, minor medication adjustments usually manage these effectively.

International patients typically receive evaluations at leading German epilepsy centers within 1 to 4 weeks. Specialized clinics may initiate medical record reviews within 24 hours. Complex treatments like deep brain stimulation or vagus nerve stimulation require comprehensive diagnostics. These often conclude within 6 to 14 days.

• Initial consultation: Appointments with neurologists are generally scheduled within 1 to 4 weeks.
• Diagnostic duration: Video-EEG monitoring or genetic exome testing usually takes 3 to 6 days.
• Emergency priority: Urgent refractory cases may receive prioritization for evaluation within 2 weeks.
• Self-pay access: International self-paying patients often secure evaluation slots faster than insurance-based cases.

Bookimed Expert Insight: German university hospitals like Charité or Solingen manage massive patient volumes, with Charité seeing over 800,000 people annually. Data shows that choosing academic centers often speeds up specialized diagnostics like molecular genetic screening. These institutions have in-house research institutes, preventing the delays caused by sending samples to external labs.

Patient Consensus: Patients note that medicine quality is high and appreciate receiving clear answers to complex questions. They emphasize that staying in constant communication with coordinators helps manage travel logistics and avoids delays in scheduling MRIs.

German epilepsy programs differentiate themselves through 3-Tesla and 7-Tesla high-field MRI for detecting subtle cortical lesions. Specialized centers integrate multimodal data using PET, SPECT, and SISCOM. Digital diagnostics like outpatient long-term video-EEG and AI-assisted video analysis bridge the gap for drug-resistant cases.

• Advanced neuroimaging: High-resolution 7T MRI identifies focal abnormalities invisible on standard scans.
• Intracranial mapping: Stereo-EEG (sEEG) provides precise seizure localization for potential surgical candidates.
• Precision medicine: Genetic screening identifies underlying syndromes to target specific pharmaceutical treatments.
• Digital diagnostics: Portable sensors allow gold-standard video-EEG monitoring within a patient home.

Bookimed Expert Insight: German university hospitals like Charité or Asklepios Altona leverage immense patient volumes to refine diagnostic accuracy. Charité serves over 800,000 patients annually. This scale allows them to integrate AI and digital imaging more rapidly than smaller regional centers, reducing the time to find a seizure focus.

Patient Consensus: Patients note that German centers often pinpoint seizure origins within days using advanced implants. Many emphasize the importance of bringing prior scans for tech integration.

Laser Interstitial Thermal Therapy (LiTT) in Germany targets drug-resistant epilepsy via MRI-guided thermal ablation. This procedure destroys seizure foci with high precision. It is ideal for deep-seated lesions like hypothalamic hamartomas. German centers use it when traditional open surgery is too risky.

• Hospital stay: Recovery typically requires only 1 to 3 days in the hospital.
• Technology used: Surgeons prioritize ROSA or Neurolocate systems for precise catheter placement.
• Success criteria: The technique effectively treats drug-resistant focal epilepsy and cavernomas.
• Safety standards: Facilities must maintain strict Unfallverhütungsvorschrift laser safety certifications.

Bookimed Expert Insight: While university hospitals like Charité Berlin and Freiburg lead in research, choosing a specialist with high procedure volumes is vital. Use the experience of doctors like Professor Horst Glasner, who has 50 years of practice. Experienced German teams often achieve 80% seizure reduction even in complex cases.

Patient Consensus: Patients note that LiTT offers a much faster recovery than a craniotomy. However, they emphasize the importance of getting a second opinion to check if the heat sink effect might limit ablation depth for certain lesions.

International patients typically stay in Germany for 2 to 3 weeks for epilepsy surgery. This period covers preoperative evaluations, the surgical procedure, and initial recovery. Most patients remain hospitalized for 4 to 7 days post-operation. Specialized implants like Vagus Nerve Stimulation require only 3 days.

• Pre-surgical phase: Evaluation lasts 3 to 7 days for diagnostic video-EEG monitoring.
• Hospital recovery: Post-operative stays usually last 4 to 7 days including ICU monitoring.
• First follow-up: The first major clinical check-up occurs 6 weeks after surgery.
• Long-term monitoring: Scheduled evaluations are required at 6 and 12 months post-operatively.
• Medication tapering: Doctors maintain anti-epileptic drug dosages for at least 1 to 2 years.

Bookimed Expert Insight: High-volume university centers like Charité Berlin or Asklepios Nord Clinic handle thousands of complex neurological cases annually. Data shows that patients opting for robotic or stereotaxic surgeries often experience shorter hospital stays. These minimally invasive approaches can reduce the initial inpatient recovery period by 2 days compared to traditional resections.

Patient Consensus: Patients emphasize staying at least 18 days total to avoid flying risks shortly after brain surgery. It is helpful to confirm a remote follow-up plan with the surgeon before traveling to manage long-term recovery from home.

Diagnostic protocols in Spain follow International League Against Epilepsy standards. Initial evaluations involve clinical history and witness accounts. Specialists perform routine or sleep-deprived EEG and high-field 3 Tesla MRI. Complex cases require 5-day video-EEG monitoring or PET scans. Genetic screening is also used for rare pediatric forms.

• Core diagnostics: Routine, sleep-deprived, or all-night EEG records electrical brain activity.
• Advanced imaging: High-field 3 Tesla MRI identifies structural brain lesions or abnormalities.
• Monitoring protocols: Inpatient video-EEG monitoring captures seizure activity during waking and sleeping.
• Expert evaluation: Top centers like Centro Médico Teknon utilize continuous EEG for drug selection.

Bookimed Expert Insight: Data shows that the most effective diagnoses in Spain come from specialized epilepsy units rather than general neurology departments. At Centro Médico Teknon, Prof. Antonio Russi has managed over 2,000 cases using a 5-day continuous video-EEG protocol. This extended monitoring often identifies specific seizure triggers that standard 20-minute EEGs miss, leading to more accurate medication selection.

Patient Consensus: Patients emphasize that finding the underlying cause is more important than just stopping seizures. Many note that recording seizures on a phone before the first appointment helps doctors reach a diagnosis much faster.

Spanish hospitals provide advanced epilepsy care ranging from personalized medication plans to minimally invasive surgeries. Specialist centers in Barcelona and Madrid offer high-resolution video-EEG monitoring and genetic screening. Modern interventions include laser interstitial thermal therapy (LITT) and neuromodulation for drug-resistant cases.

• Diagnostic monitoring: Continuous 24/7 video-EEG identifies specific seizure origins.
• Minimizing invasiveness: Laser thermal therapy (LITT) treats brain tissue through tiny openings.
• Neuromodulation devices: Vagus nerve stimulation (VNS) reduces seizure frequency via electrical pulses.
• Expert consultation: Leading epileptologists like Dr. Antonio Russi offer personalized drug selection.

Bookimed Expert Insight: Data from Centro Médico Teknon shows that detailed EEG monitoring often avoids surgery. Prof. Antonio Russi has helped over 2,000 patients achieve seizure freedom using non-surgical adjustments. Choosing a clinic with 24/7 bedside monitoring ensures doctors capture the exact seizure trigger point.

Patient Consensus: Patients note that finding the specific cause of seizures is crucial for treatment success. Many emphasize that high-quality EEG data from Barcelona centers helped them find effective medications after years of failure.

Barcelona, Madrid, and Pamplona house Spains leading epilepsy units. These cities offer specialized centers with Joint Commission International accreditation and multi-disciplinary teams. Facilities like Teknon Medical Center in Barcelona provide advanced robotic Stereo-EEG and personalized drug mapping for drug-resistant cases.

• Barcelona excellence: Prof. Antonio Russi at Teknon has treated over 2,000 complex epilepsy cases.
• Pediatric focus: Sant Joan de Déu coordinates the European Reference Network for Rare Epilepsies.
• Madrid centers: Hospital Ruber Internacional maintains over 40 years of specialized functional neurosurgery experience.
• Pamplona technology: Clinica Universidad de Navarra offers advanced Dravet syndrome units and video-EEG monitoring.

Bookimed Expert Insight: Barcelona is the clear leader for international patients seeking high-volume expertise. Prof. Antonio Russi at Teknon is requested by 75% of Bookimed epilepsy patients. While basic diagnosis starts around $4,200, comprehensive 5-day inpatient monitoring costs approximately $20,850. This higher tier includes constant video surveillance to capture and analyze specific seizure triggers accurately.

Patient Consensus: Families often find that Spanish specialists identify the root cause of seizures when other clinics fail. Patients recommend staying at least 3 to 6 days for EEG monitoring to ensure the most accurate medication adjustments.

EU prescriptions are legally valid in Spain if they include the active ingredient and doctor credentials. Non-EU prescriptions from the USA or UK are generally not accepted at pharmacies. You must visit a local neurologist to re-issue your medication as a Spanish e-receta.

• EU requirements: Must list patient date of birth, doctor signature, and the generic drug name.
• Non-EU protocols: Patients must present a medical report to a Spanish doctor for local re-issuance.
• Controlled substances: Medications like psychotropics require additional approval from the Spanish Agency of Medicines (AEMPS).
• Supply limits: Travelers may bring a 3-month personal supply in original packaging with medical reports.

Bookimed Expert Insight: While public system registration can take weeks, private clinics like Centro Médico Teknon provide faster access. Dr. Antonio Russi often provides initial drug adjustments within 1–5 days of inpatient monitoring. Complex cases may require specific EEG-based dosing that general pharmacies cannot authorize without a specialist report.

Patient Consensus: Patients note that pharmacy systems are strictly digital and region-locked. Most suggest booking a private neurologist appointment immediately upon arrival to avoid gaps in medication like levetiracetam or valproate.

Turkey offers advanced epilepsy surgeries including resective surgery, Vagus Nerve Stimulation (VNS), and Deep Brain Stimulation (DBS). These procedures are performed in JCI-accredited centers following international safety protocols. Reported success rates for seizure reduction range from 70% to 99.9% depending on the specific technique used.

• Resective surgery: Curative removal of brain tissue causing seizures with 50-80% long-term freedom rates.
• Vagus nerve stimulation: Pulse generator implants reduce seizure frequency by 28-50% initially for non-resectable cases.
• Deep brain stimulation: Thalamic electrodes regulate abnormal activity for drug-resistant, multifocal epilepsy with high precision.
• Safety standards: Procedures maintain high safety profiles with reported procedural success rates up to 99.9%.

Bookimed Expert Insight: Clinical data shows a major distinction between standard private clinics and university-affiliated hospitals like Medipol Mega or Istinye University. These academic centers integrate research directly into care. For example, Dr. Ali Zirh at Medipol has performed over 1,400 DBS procedures. This high volume often leads to better electrode placement precision compared to smaller general neurosurgery departments.

Patient Consensus: Patients note that initial sessions for stimulator programming are vital for long-term success. Many emphasize the relief of seeing normal EEG results for the first time after decades of uncontrolled seizures.

Suitable candidates for epilepsy surgery in Turkey include patients with drug-resistant seizures that fail to respond to two or more medications. Candidates must have a clearly identifiable seizure focus that surgeons can safely remove. Candidates include those with focal epilepsy, cortical dysplasia, or lesional brain disorders.

• Drug resistance: Seizures continue despite using safe doses of two or more effective anti-seizure medications.
• Localizable focus: Imaging such as 3-T MRI and video-EEG must pinpoint a single seizure origin.
• Functional safety: The surgical site must not overlap with vital areas for speech or movement.
• Neuromodulation candidates: Patients with non-localized seizures may qualify for Vagus Nerve Stimulation or Deep Brain Stimulation.

Bookimed Expert Insight: While many international protocols are strict, Turkish centers like NP Istanbul Brain Hospital often prioritize pediatric cases. They utilize specialized sedation during 3-T MRI and EEG to ensure accurate mapping in children. This approach allows younger patients to qualify for surgery earlier than in many Western systems. Data shows these specialized diagnostics typically cost around $2,450, providing a high-resolution roadmap for surgical success.

Patient Consensus: Patients emphasize that getting a correct diagnosis in Turkey often reverses years of incorrect treatment. They note that nighttime seizures can improve significantly after advanced procedures like Vagus Nerve Stimulation.

Physical healing after epilepsy surgery typically requires 4 to 6 weeks. Neurological stabilization and cognitive recovery often span 12 to 24 months. Long-term seizure freedom reaches 60% to 70% for temporal lobe resections. Patients often experience a delayed response as the brain adapts post-operatively.

• Hospital stay: Most patients remain hospitalized for 3 to 7 days for monitoring.
• Activity restrictions: Strenuous exercise and driving are restricted for at least 6 weeks.
• Medication tapering: Doctors typically wait 12 to 24 months before reducing anti-seizure medications.
• Success rates: Approximately 47% to 67% of patients remain seizure-free 5 years after surgery.

Bookimed Expert Insight: Data shows a major gap between basic diagnostics and surgical readiness. While many facilities offer standard EEGs, specialized centers like NP Istanbul Brain Hospital use functional neuroimaging and thought-focused medicines. These advanced tools help surgeons like Dr. Baris Metin map brain functions more precisely. This level of detail is critical because 47% of eventually seizure-free patients don't see immediate results. They achieve success only after the brain undergoes a delayed adjustment period.

Patient Consensus: Patients often note that memory gaps and word-finding difficulties are common during the first 8 weeks. Many emphasize that early `swelling-related` seizures don't mean the surgery failed, as long-term stability often takes a full year.

Istanbul and Ankara are the primary Turkish hubs for epilepsy surgery, housing JCI-accredited centers with advanced neuroimaging. Leading facilities like Medipol Mega and Memorial Şişli offer specialized procedures including deep brain stimulation and vagus nerve stimulation. These institutions feature multidisciplinary teams with international training from US and European clinical centers.

• Specialized centers: NP Istanbul Brain Hospital is Europes second-ranked neuropsychiatric hospital.
• Surgical expertise: Dr. Ali Zirh has performed over 1,400 deep brain stimulation procedures.
• Advanced diagnostics: Anadolu Medical Center utilizes Johns Hopkins protocols and 3T MRI technology.
• Pediatric care: Medipol Mega and Liv Hospital Ulus feature dedicated pediatric neurology specialists.

Bookimed Expert Insight: Coordination between neurologists and neurosurgeons is the most critical factor for surgical success. Data shows that top-rated clinics like Medipol Mega and NP Istanbul integrate functional neuroimaging with microelectrode recording. This level of detail is rarely found in general neurosurgery departments. Patients should prioritize clinics with dedicated epilepsy programs rather than general neurology wards for better long-term seizure control.

Patient Consensus: Patients highlight that having a dedicated interpreter during consultations with specialists like Dr. Kursad Aydin makes complex medical explanations much easier to understand. Many emphasize that finally achieving a normal EEG after years of uncontrolled seizures was a life-changing result of their specialized surgical treatment.

Patients should plan to stay in Turkey for 14 to 28 days for comprehensive epilepsy management. This window covers advanced diagnostics like video EEG monitoring and complex neurosurgery. Recovery from procedures like vagus nerve stimulation requires roughly 7 to 10 days before flying.

• Diagnostic phase: Intensive video EEG monitoring typically requires 3 to 7 days of inpatient observation.
• Surgical stay: Vagus nerve stimulation (VNS) involves approximately 5 days of specialized hospitalization.
• Stem cell recovery: Regenerative therapy packages often include a 16-day hotel stay for monitoring.
• Follow-up care: Surgeons typically require 14 days post-op to manage potential swelling or seizures.

Bookimed Expert Insight: While general surgeries in Turkey average 10 days, epilepsy cases often double this timeline due to diagnostic requirements. For example, NP Istanbul Brain Hospital focuses on brain function measurements that may extend stays. Many specialized packages, like those at Liv Hospital Ulus, already incorporate 16-day hotel stays to ensure patient safety during the critical early recovery phase.

Patient Consensus: Patients emphasize the need for flexible, refundable flight tickets because diagnostic delays or seizure observation can unexpectedly extend the trip. Those undergoing VNS surgery noted that while the procedure is quick, staying nearby for the initial device connection is vital.

Typical epilepsy surgery packages in Turkey include specialized diagnostics, the surgical procedure, and multi-day hospitalization. These bundles often cover JCI-accredited facility fees, neurosurgeon consultations, and VIP transfers. Some comprehensive plans also provide language assistance and remote follow-up consultations for 3 to 6 months after discharge.

• Diagnostic work-up: Includes video-EEG, 3T MRI with contrast, and PET-CT scans for focus mapping.
• Surgical intervention: Covers procedures like temporal lobectomy, VNS implantation, or deep brain stimulation.
• Hospital stay: Packages typically include 1 to 10 days in a private hospital room.
• Logistics support: Most bundles provide airport-to-clinic VIP transfers and professional multilingual medical interpreters.

Bookimed Expert Insight: Our data shows a distinct value gap between resective surgery and neuromodulation packages. While temporal lobectomy packages like those at Memorial Atasehir Hospital cost around $36,200, Vagus Nerve Stimulation (VNS) at Istinye Medical Park is approximately $25,000. Patients choosing neuromodulation should confirm if the physical device brand, such as Medtronic, is included in the base price.

Patient Consensus: Patients emphasize that while transfers and meals are usually included, anti-seizure medications for the first few months post-discharge typically require an extra budget. Many note the importance of having an English-speaking coordinator available 24/7 during their stay in Istanbul.