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 hemispheres of the brain. This procedure is also called callosal sectioning or split-brain surgery.
Who benefits from a Corpus Callosotomy?
This surgery helps people who experience many a lot of atonic seizures despite taking antiseizure medications. A person experiencing an atonic seizure suddenly loses muscle strength and collapses or drops to the ground. That 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 surgery, these seizures tend to be less severe because they only affect half of the brain.
What to Expect from 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.
Preparing for Surgery
Your provider might suggest certain tests in order to get an accurate read of the brain. Electroencephalography (EEG), for example, looks at your brain waves. A magnetic resonance imaging (MRI) machine, on the other hand, gives a detailed image of your tissues. Or, a positron emission tomography (PET) scan shows how the brain is working.
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:
A Week Before Surgery
A week before brain surgery, we will contact you to:
- Gather a health history, including details about medicines (name, dose, frequency), pharmacy and primary care doctor.
- Discuss what to expect on the day of surgery and during the hospital stay.
- Let you know what you’ll need when you leave the hospital.
Maintain a Healthy Diet and Regular Activity
Overall health can affect how well and how quickly a person recovers from surgery. In general, kids and adults should maintain regular levels of activity and physical therapy leading up to surgery.
Before and after the surgery, make sure the daily diet has enough food with iron, calcium, and vitamins C and D. Fresh colorful fruits and vegetables, dairy food, and other products with added iron and calcium offer great ways to get these nutrients.
Sometimes fears, behavior or expectations related to upcoming surgery can cause stress for families. Contact your primary health care provider or Gillette Child and Family Services for support.
We can also help with resources that might reduce anxiety for your family. Our child life specialists can provide emotional support and distractions, such as toys and movies in the waiting area before surgery begins. Child life specialists can also meet with your child’s siblings to address their feelings and concerns.
Knowing what to expect can help everyone feel more prepared. We’ll take time to clarify short- and long-term expectations for individual outcomes following surgery.
During Your Hospital Stay
The Day of Surgery
The perianesthesia (pre-surgical) staff welcome you when you arrive. We measure weight and ask the person to change into a hospital gown. We also check temperature, pulse and blood pressure. A child life specialist can help your child feel more at ease with toys, crafts or movies if needed.
Next, you meet with the surgery team, which includes:
- (Pediatric) neurosurgeon
- Nurse anesthetist
This is a chance for you to raise any questions or concerns. The anesthesiologist discusses how anesthesia and pain medicine are used during surgery. You can talk about you or your child’s experiences with pain and request medicine or other techniques to help them relax.
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.
Rehabilitation and Recovery
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 if a person has side effects and the extent of the callosotomy.
A corpus callosotomy does not stop all seizures, so it's expected you'll remain on antiseizure medications after the procedure. During recovery, you may temporarily experience:
- Feelings of depression
- Memory problems
- 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
Your child will work with a wide range of specialists. Along the way, they may receive care from internationally recognized experts in areas including:
- Pediatric Rehabilitation Medicine
- Child life
- Rehabilitation therapies
- Radiology and imaging
- Social work
We provide lifelong support and education in a family-centered environment. Our multidisciplinary team will work closely with you to develop a customized treatment plan to fit your child's specific needs.