Case report and review of the literature
This procedure has no impact on partial seizures, which arise focally from a specific part of the brain. Corpus callosotomy callosal sectioning is quite effective in reducing seizure frequency in patients who have generalized epilepsy with drop attacks. It is generally reserved for this selected population.
It is not a curative epilepsy surgery procedure, but is rather considered palliative. Callosal sectioning is often done in stages. The anterior two-thirds of the corpus callosum is sectioned first. Then, if necessary, the posterior one-third is sectioned in a second surgical procedure.
Epilepsy surgery - Mayo Clinic
Generally, a frontal craniotomy is performed adjacent to the midline. One hemisphere the nondominant one, usually the right is gently retracted to expose the corpus callosum, which lies at the depth between the two hemispheres.
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Microsurgical technique is used to section the corpus callosum in the midline. Great care is exercised to prevent injury to the adjacent anterior cerebral arteries during this procedure. One risk of the procedure is that the patient tends to neglect the nondominant extremities initially, but recovery usually occurs within a few weeks.
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Neglect of the nondominant extremities is likely to be more profound after complete corpus callosotomy. Other interhemispheric white-matter pathways become more functional with time. Complete callosal sectioning can cause some permanent deficits. When the patient's eyes are closed, one side of the brain does not cooperate with the other in even simple tasks, so the right and left extremities may carry out conflicting movements. With eyes open, the patient can compensate for this problem. These complications are called disconnection syndromes. More serious complications are exceedingly rare.
In the early days of callosal sectioning, before the development of modern neurosurgical techniques and advances in microsurgery, problems were more frequent.
All epilepsy surgery involves the brain. The operations generally involve removal of epileptogenic tissue from the area where seizures arise or interruption of nerve pathways along which seizure impulses spread. The most common form of epilepsy surgery is a lobectomy or cortical resection. With recent refinements in diagnostic methods, the procedure is now available to more people.
It is estimated that approximately 30 percent of persons with partial epilepsy have seizures that are not well controlled with medications and could benefit from this surgery. All or part of a left or right lobe may be removed surgically. These areas of the brain are common sites of simple and complex partial seizures, some of which may secondarily generalize. Seizures in the temporal, parietal, frontal or occipital lobes may be treated surgically if the seizure-producing area can be safely removed without damaging vital functions.
The operations described above usually remove a relatively small area of the brain.
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While it seems impossible that someone could function with only half a brain the other side fills up with fluid , children manage to do so because the half that remains takes over many of the functions of the half that was removed. Weakness on the side opposite the operation will continue, however. Hemisperectomies may also be performed when children are born with conditions that cause excessive damage to one side of the brain, such as bleeding in the brain prior to birth.
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Sectioning, or separating, the corpus callosum a nerve bridge which connects the two halves of the brain and integrates its functions was first reported in the medical literature in By separating the cerebral hemispheres, the spread of an epileptic discharge can be confined to one cortex, reducing generalized seizures.