This specialized neurosurgery involves severing the corpus callosum—the bridge connecting brain hemispheres—to prevent seizures from spreading between the left and right sides.
Success rates are impressive for specific seizure types: 50-75% of patients experience complete elimination of drop attacks, while generalized tonic-clonic seizures improve in 60-80% of cases.
Candidates typically have Lennox-Gastaut syndrome or other severe epilepsy syndromes with frequent atonic seizures causing dangerous falls and injuries despite trying multiple antiepileptic drugs.
The procedure may be performed in stages—partial callosotomy first (cutting front two-thirds), then complete if needed—to minimize disconnection syndrome side effects like speech difficulties and hand coordination problems.
Recovery involves 2-4 days hospitalization followed by 6-8 weeks of rehabilitation, with most patients requiring continued antiseizure medications at potentially lower doses post-surgery.
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.
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.
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.
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.
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.
While corpus callosotomy doesn't cure epilepsy, it can dramatically reduce the most dangerous seizure types that cause falls and injuries in medication-resistant cases. The decision requires weighing significant quality-of-life improvements against potential cognitive and motor side effects. If you're dealing with severe, uncontrolled epilepsy, Doctronic can help connect you with specialists to explore all treatment options.
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