Medically Reviewed by Dr. K on 13 May 2022.
Table of contents
- What Is a Corpus Callosotomy?
- Who Is a Candidate for a Corpus Callosotomy?
- What Happens Before a Corpus Callosotomy?
- What Happens During a Corpus Callosotomy?
- What Happens After a Corpus Callosotomy?
- How Effective Is a Corpus Callosotomy?
- What Are the Side Effects of Corpus Callosotomy?
- What Are the Risks of a Corpus Callosotomy?
What Is a Corpus Callosotomy?
The corpus callosum is a network of nerve fibres that runs deep inside the brain and connects the two halves (hemispheres). It aids communication between the hemispheres, but it also aids the spread of epilepsy impulses from one side of the brain to the other. A corpus callosotomy is a procedure that severs (cuts) the corpus callosum, preventing seizures from spreading from one hemisphere to the other. Seizures usually don't go away entirely after this treatment (they continue on the side of the brain in which they originate). However, since the seizures cannot travel to the other side of the brain, they typically become less intense.
Who Is a Candidate for a Corpus Callosotomy?
If both sides of the brain are affected by repeated seizures, a corpus callosotomy, often known as split-brain surgery, can be used to help patients with the more severe and uncontrollable types of epilepsy. People who are candidates for corpus callosotomy are usually those who have not responded to anti-seizure drugs (antiepileptics).
What Happens Before a Corpus Callosotomy?
Pre-surgery testing for corpus callosotomy candidates includes epilepsy screening, electroencephalography (EEG), magnetic resonance imaging (MRI), and positron emission tomography (PET) (PET). These studies assist the doctor in determining the origin of the seizures and how they occur across the brain. It also aids the doctor in determining whether a corpus callosotomy is the best treatment option.
What Happens During a Corpus Callosotomy?
A corpus callosotomy necessitates opening the brain with a craniotomy operation. The surgeon makes an incision in the skull, cuts a slice of bone, and draws out a part of the dura, the tough membrane that protects the brain, after the patient has been put to sleep with anaesthesia. The surgeon then inserts special instruments to disconnect the corpus callosum from this “window." To enter the corpus callosum, the surgeon gently divides the hemispheres. Surgical microscopes are used to provide a magnified vision of brain structures to the surgeon.
A corpus callosotomy can be performed in two stages in some cases. The front two-thirds of the frame are cut in the first process, but the back portion is left intact. As a result, the hemispheres will begin to share visual data.
If the severe seizures persist, the rest of the corpus callosum will be cut in a second surgery. The dura and bone are reattached after the corpus callosum is sliced, and the scalp is stitched or stapled closed.
What Happens After a Corpus Callosotomy?
The patient typically spends two or four days in the hospital. Most people who have a corpus
callosotomy will resume their daily activities, such as work or education, six to eight weeks after surgery. Hair will develop back in the region around the incision, concealing the surgical wound. The person will continue to take anti-seizure medication.
How Effective Is a Corpus Callosotomy?
In about 50% to 70% of cases, corpus callosotomy is effective in preventing drop attacks, or atonic seizures in which a person loses muscle tone and falls to the ground. This will reduce the risk of injuries while also improving the individual's quality of life.
What Are the Side Effects of Corpus Callosotomy?
Following a corpus callosotomy, the following signs can appear, but they usually go away on their own:
- Scalp numbness
- Feeling tired
- Difficulty speaking
- Difficulty remembering things
- Difficulty finding words
- Loss of sensation
- Change in personality
What Are the Risks of a Corpus Callosotomy?
While serious complications from a corpus callosotomy are rare, there are risks, including:
- Risks associated with surgery, including infection, bleeding, and an allergic reaction to anesthesia
- Swelling in the brain
- Lack of awareness of one side of the body
- Loss of coordination
- Problems with speech, such as stuttering
- Increase in partial seizures (occurring on one side of the brain)
Reference on 2.3.2021:
- Epilepsy Foundation https://www.epilepsy.com/living-epilepsy/epilepsy-and/professional-health-care-providers/diagnosis-treatment/surgery/corpus-callosotomy
- New York University Langone Medical Center.