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What is a corpus callosotomy?
A corpus callosotomy is a surgical treatment for different forms of epilepsy. Epilepsy is a chronic condition that causes recurrent seizures in children and adults.
The corpus callosum is a band of nerve fibers that carry messages between the brain’s two halves, called hemispheres. During a corpus callosotomy, a neurosurgeon cuts the brain’s corpus callosum. A corpus callosotomy stops seizure signals from going back and forth between the two halves (hemispheres) of the brain. This procedure is also called callosal sectioning or split-brain surgery.
Who benefits from a corpus callosotomy?
A corpus callosotomy helps people who experience a lot of atonic seizures despite taking anti-seizure medications. A person experiencing an atonic seizure suddenly loses muscle strength and collapses or drops to the ground, which is why atonic seizures are also known as "drop seizures" or "drop attacks." An atonic seizure increases the risk of injuries, including broken bones and concussions.
A corpus callosotomy is not an effective treatment for people who experience partial or focal seizures. These seizures develop in a small region, or focal point, of the brain.
How does a corpus callosotomy help?
A cut corpus callosum can’t send seizure signals from one side of the brain to the other. Seizures still occur on the side of the brain where they start. After a corpus callosotomy, these seizures tend to be less severe because they only affect half of the brain.
What should I expect after a corpus callosotomy?
A corpus callosotomy is irreversible: once the corpus callosum is cut, it cannot be repaired.
Corpus callosotomy side effects can be minor. For example, some people can smile before surgery but immediately after surgery will not be able to. It will take time for skills like smiling to return.
Studies show that a corpus callosotomy is an effective way to reduce — and sometimes completely stop — atonic seizures. The surgery may greatly improve quality of life. Discuss the benefits and risks of epilepsy surgery with your provider.
How should I prepare for a corpus callosotomy?
You can help ensure the best possible surgical outcome by understanding what to expect before, during and after a corpus callosotomy surgical procedure at Gillette Children’s. Here are a few resources to help you feel more prepared:
What should I expect on the day of a corpus callosotomy?
A corpus callosotomy takes place under general anesthesia, which means the person is asleep throughout the procedure. Your neurosurgeon will perform a craniotomy, opening the skull to access the brain.
During the procedure, your surgeon:
- Removes a piece of the skull.
- Peels back a section of the dura, the tough membrane that protects the brain.
- Uses surgical microscopes to insert special instruments to cut the corpus callosum.
- Replaces the dura.
- Uses stitches or staples to secure the skull bone back into place.
Sometimes, a corpus callosotomy procedure takes place in two stages. During the first stage, your neurosurgeon cuts only the front part of the corpus callosum. This approach allows the two brain sections to continue sharing visual information. If you continue to have frequent, severe seizures your doctors may consider a second surgery to sever the corpus callosum completely.
Everyone heals differently, and outcomes depend on neurologic condition before surgery.
You’ll spend several days in the hospital. You should be able to get back to everyday activities within six to eight weeks. Some patients take longer to recover than others. It depends on a lot of factors, such as the extent of the callosotomy or if a person experiences side effects after surgery.
A corpus callosotomy does not stop all seizures, so it's expected you'll remain on anti-seizure medications after the procedure. During recovery, you may temporarily experience:
- Fatigue
- Feelings of depression
- Headaches
- Memory problems
- Nausea
- Numbness at the incision site
- Speech difficulties
You should call your healthcare provider if you experience:
- Fever or other signs of infection at the incision site (skin is red, tender or has yellow discharge)
- More severe or frequent seizures
- Severe headaches or nausea
- Signs of stroke (slurred speech, blurred vision or sudden paralysis, often on one side of the body)
- Speech problems
Corpus Callosotomy Services at Gillette Children's
Your child will work with a wide range of specialists. Along the way, they may receive care from internationally recognized experts in areas including:
