Corpus Callosotomy: A Surgical Treatment for Severe Epilepsy | Understanding the Procedure and Its Effects

If you or a loved one has been diagnosed with severe epilepsy that hasn't responded well to medication, your doctor may suggest a corpus callosotomy. This surgical procedure can help reduce the severity and frequency of seizures, improving quality of life for those with difficult-to-control epilepsy.

What Is a Corpus Callosotomy?

A corpus callosotomy, sometimes called "split-brain surgery," is a procedure that involves cutting the corpus callosum, a band of nerve fibers deep in the brain that connects the two hemispheres. By severing this connection, the spread of seizures from one side of the brain to the other is disrupted, making the seizures less severe.

Who Is a Candidate for a Corpus Callosotomy?

Corpus callosotomy is typically considered for people with the most severe and uncontrollable forms of epilepsy, particularly those who experience seizures that affect both sides of the brain and do not respond well to antiseizure medications. Candidates for this surgery undergo an extensive evaluation to determine if the procedure is appropriate for their specific situation.

What Happens Before, During, and After a Corpus Callosotomy?

Before the surgery, patients undergo a thorough evaluation that may include:

• Seizure monitoring

• Electroencephalography (EEG)

• Magnetic resonance imaging (MRI)

• Positron emission tomography (PET)

During the corpus callosotomy, the patient is put under anesthesia, and the surgeon accesses the brain through a craniotomy. Using surgical microscopes and special instruments, the surgeon carefully separates the hemispheres and cuts the corpus callosum. In some cases, the procedure is done in two stages to minimize potential side effects.

After the surgery, patients typically stay in the hospital for two to four days and can return to normal activities within six to eight weeks. They will continue taking antiseizure medications as prescribed by their doctor.

Effectiveness, Side Effects, and Risks of Corpus Callosotomy

Corpus callosotomy is successful in stopping drop attacks, or atonic seizures, in about 50% to 75% of cases. While the procedure can significantly improve quality of life, it does come with some potential side effects and risks, such as:

• Temporary scalp numbness, nausea, fatigue, or headaches

• Difficulty speaking, remembering, or finding words

• Paralysis, weakness, or loss of sensation

• Changes in personality

• Swelling in the brain

• Lack of awareness of one side of the body

• Loss of coordination

• Increase in partial seizures

• Stroke (rare)

It's essential to discuss the potential benefits, risks, and side effects of corpus callosotomy with your healthcare team to determine if this surgical treatment is right for you or your loved one. With proper care and monitoring, a corpus callosotomy can lead to a significant reduction in seizure severity and an improved quality of life for those with severe epilepsy.

For more information on corpus callosotomy and other epilepsy treatments, consult with your neurologist or visit reputable websites such as the Epilepsy Foundation, National Institute of Neurological Disorders and Stroke, or the American Academy of Neurology.