Corpus Callosotomy Surgery is a surgical technique performed to alleviate severe uncontrolled epileptic seizures. This type of surgery is usually advised for children who experience drop attacks or generalized seizures and cannot be controlled with medications. This type of surgery works by partially disconnecting the corpus callosum (a bundle of nerve fibers connecting the two hemispheres of the brain), which helps in controlling the spread of seizure activity between the two hemispheres. Understanding the treatment for corpus callosotomy surgery is essential for those considering this option.
If you or someone close to you has been diagnosed with drug-resisted epilepsy, familiarizing yourself with corpus callosotomy treatment options can be life-changing. This guide explains the entire treatment journey from indications to aftercare.
Why Corpus Callosotomy is Performed
Treatment for Corpus Callosotomy Surgery
As with any surgical operation, Treatment for Corpus Callosotomy Surgery is not a primary intervention. It is only considered in these situations:
- Existing medications are ineffective (drug resistant epilepsy).
- Seizures are global, with multiple neurological loci acting in concert, leading to generalized seizures from more than one area of the brain.
- There is a high incidence of drop attacks (atonic seizures) that result in injury.
- There are instances where partial seizures become generalized and result in violent convulsions.
The lead objective of the surgery is not to eliminate all seizures, but rather to curtail dangerous seizure spread; therefore making them easier to manage.
Pre-Surgical Evaluation
Before one from the neurology or neurosurgery team suggests corpus callosotomy, they have aStandard EEG and MRI checks they do as part of a pre-surgical assessment:
- EEG (Electroencephalogram):
This test helps the doctors locate the origin of the seizures by detecting electrical activity in the brain.
- MRI and CT Scans:
Assessed MRI and CT scans are used to evaluate the27 mm/ lesions on the cerebrum.
- Psychological Review:
Through EEG’s the patient’s memory, language and general cognitive skills are evaluated in order to understand possible the post-surgical effects.
- Seizure Tracking:
Patients in the EMU have video-EEG monitoring done continuously, which helps in understanding different types of seizures and their frequency.
Types of Corpus Callosotomy
Depending on the patient’s condition, the procedure may vary in extent:
- Partial Callosotomy: Front two-thirds of the corpus callosum are cut with less invasive approach. This is ideal for patients suffering from moderate cases.
- Complete Callosotomy: In circumstances where outcomes from a partial surgery are not enough, the entire corpus callosum is transected.
The Surgical Procedure:
This is usually done under general anesthesia. It consists of:
- Craniotomy: This is done by opening a small portion of the skull giving access to the brain.
- Corpus Callosum Identification: Using neuronavigation and microscope tools, the corpus callosum is identified.
- Severing the Nerve Fibers: The connecting nerve fibers discovered to be associating between the two sides of the brain are carefully cut by the surgeon so communication between the hemispheres is lost.
- Closure: The incision is stitched and the skull bone is replaced.
Post-surgical care and recovery
The patient is moved to the ICU for close observation. Here is how the rest of the recovery journey looks:
- Hospital Stay:
Patients usually remain in the hospital, depending on their condition, for about 3 – 7 days.
- Physical Therapy:
Some could require occupational and physical therapy to rebuild coordination and strength.
- Seizure Activity Monitoring:
Physicians continue evaluating seizure activity to assess the surgery’s effectiveness.
- Medication Management:
Though anti-epileptic drugs (AEDs) may still be needed, some doses can be reduced.
- Follow Up Visits:
These are essential to assess changes in functions after surgery and manage any side effects.
Advantages Obtained From Corpus Callosotomy
- Marked reduction in drop attacks and other dangerous seizure types.
- Enhanced safety and quality of life, notably in younger patients.
- Reduced the spread of seizures allowing for easier control with medications.
- Lower risk of injury from fewer generalized seizures.
Risks and Complications
Corpus Callosotomy, like other forms of brain surgery, has its potential risks, such as:
- Difficulties with speech and language
- Problems with memory or focus
- Coordination, weakness, or strength difficulties
Bleeding or infection
- Very rarely some patients could develop “disconnection syndrome” which is a rare condition characterized by problems in the coordination of body sides.
- These risks are taking into consideration by the surgical team, and the procedure is only performed when the benefits greatly outweigh the potential complications.
Who Is An Ideal Candidate?
It is still recommended for:
- Children and adults that have drop attacks with a risk of injury.
- Patients with generalized epilepsy who do not respond to medical treatment.
- Patients who cannot have surgically removable epileptogenic zones.
- Patients who are not candidates for focal resection because of multiple seizure foci.
Alternative Treatment Options
Some cases of vertebral fractures or osteoporotic vertebral fractures would benefit from an alternate form of treatment. Some other alternatives are:
- Vagus Nerve Stimulation (VNS)
- Responsive Neurostimulation (RNS)
- Ketogenic Diet
- Coronal plane of resection with other resective procedures in epilepsy.
Before corpus callosotomy is performed, a comprehensive epilepsy center will exhaust all other treatment options first.
Conclusion
For patients with severe, uncontrolled seizures, Treatment for Corpus Callosotomy Surgery provides an essential treatment option, especially when traditional therapies do not help. This surgery improves the patient’s safety and quality of life by disconnecting one of the pathways that communication depends on the two hemispheres of the brain and the spread of debilitating seizures.
If you or someone you care about has unmanaged epilepsy, an experienced neurologist or epilepsy surgeon can help determine whether corpus callosotomy could be the next step toward a life without seizures.
