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Corpus Callosotomy

What Is Corpus Callosotomy?

A corpus callosotomy is the surgical separation of the right and left brain hemispheres. The corpus callosum is the largest pathway between the two cerebral hemispheres; this connection of white matter contains a bundle of nerve fibers.

A partial callosotomy divides the front two-thirds of the corpus callosum, leaving the back portion intact to retain more of the connection and brain’s communication. A complete callosotomy disconnects both the anterior and posterior portions of the corpus callosum from the right and left cerebral hemispheres.

What Condition Does Corpus Callosotomy Treat?

The microsurgical technique (microscopes and small instruments are used) treats intractable epilepsy that is drug-resistant. Particularly seizures that start in one area of a hemisphere and then spread to the other hemisphere; by severing the pathway between the hemispheres, the abnormal electrical activity on one side is unable to travel to the other side and escalate the seizure.

Specific types of refractory (or unmanageable) epilepsy are most suited to this form of brain surgery:

  • Atonic Seizures — tonic means with muscle tone or tension, a means without. Those suffering from atonic seizures lose their normal muscle tone and can fall, having a “drop attack.” These falls can cause serious injuries. Those with Lennox-Gastaut Syndrome (LGS) that are not helped by medications or other treatments and have atonic seizures may be candidates for corpus callosotomy surgery.
  • Secondary Generalized Seizures — the electrical discharge starts in one area of the brain (complex partial seizure) and then spreads (secondarily) to the other hemisphere (generalized). The first tonic phase (stiffening of the muscles) is often followed by the clonic phase (quick contractions).
  • Tonic Seizures that cause uncontrolled epilepsy and have a high risk of injury may also be treated with this type of split-brain surgery.

Candidates for this type of brain operation will have tried anti-seizure medications and other conservative treatments before considering this form of epilepsy surgery.

State-of-the-Art Corpus Callosotomy Treatments at NSPC

At Neurological Surgery, P.C. (NSPC), a team of medical specialists such as neurosurgeons, neurologists, neuropsychologists and neuro-epileptologists will help determine if a microsurgical corpus callosotomy procedure will help minimize the spread of electrical discharges contributing to your seizures.

Our brain imaging experts use a variety of tools to pinpoint the brain abnormalities:

  • functional MRI (magnetic resonance imaging) of the brain,
  • EEG (electroencephalogram) and video-EEG to monitor and track the electronic brain activity,
  • PET (Positron Emission Tomography) Scan,
  • SPECT (Single Photon Emission Computed Tomography) Scan, and
  • other neuropsychological examinations that are used in our state-of-the-art facilities.

During the corpus callosotomy procedure, the patient is under general anesthesia and a portion of the scalp is shaved. An experienced neurosurgeon carefully performs a craniotomy to open up the cranium and the dura (membrane that covers the brain) to view the corpus callosum. With microsurgical instruments, the nerve bundle is segmented: the anterior portion for a partial callosotomy or the entire nerve fiber cluster for a complete callosotomy. The dura, cranium and scalp are then closed up.

With offices throughout New York’s Queens, Nassau and Suffolk Counties, NSPC is one of the northeast’s largest private practices of leading doctors and allied specialists. Our seasoned neurosurgeons and skilled medical staff means you get top level surgical care for your epilepsy, here in the NY metro region.

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