What Is Corpus Callosotomy?
Corpus Callosotomy (CC) is a surgical procedure to control generalized seizures in children, primarily atonic seizures (drop attacks) or tonic seizures, by disconnecting the corpus callosum. The corpus callosum is a band of tissue that connects and transmits messages from one side of the brain to the other. CC does not involve removing any portion of the brain.
Some children with generalized seizures who don’t have an identifiable focus that can be resected may also be candidates for CC. Drop attacks can cause serious injuries to the child, and CC surgery has been shown to reduce falls for about 70 percent of patients. This surgery may or may not decrease the occurrence of other seizure types.
What to Expect Before Corpus Callosotomy Surgery
Children are given a general anesthesia prior to the surgery. To prepare for the surgery, part of your child’s hair will be shaved.
What Happens During Corpus Callosotomy Surgery?
At UPMC Children’s Hospital, most CC procedures are performed using a minimally invasive technique called laser callosotomy (Stereotactic Laser Interstitial Thermal Ablation Callosotomy of LITT-CC). With this approach, three or four small probes are inserted into the corpus callosum using a special stereotactic robot. The probes are then heated in a precise fashion to generate the disconnection.
We also perform traditional corpus callosotomy. In the traditional approach, an incision will be made and a craniotomy will be performed (removal of a piece of the skull that will be replaced at the end of the surgery). Using microsurgical techniques, the space between the two halves of the brain will be entered and the anterior two-thirds of the corpus callosum will be sectioned (partial callosotomy). The posterior one-third may also require sectioning (complete callosotomy), or this can be done later during a second procedure.
What to Expect After Corpus Callosotomy Surgery
Your child will be in the Intensive Care Unit (ICU) overnight or until he or she is medically stable enough to go to another nursing unit. While still in the ICU, your child will be observed continuously and blood pressure, pulse and respiration will be checked frequently.
After laser callosotomy, your child will usually be in the hospital one or two days. After traditional callosotomy, your child will probably require five to seven days of hospitalization. Inpatient or outpatient rehabilitation may be necessary to optimize your child’s functioning. Your child will be evaluated carefully over the next few months to monitor their progress.
Potential Complications of Corpus Callosotomy in Children
As with any surgery, there are risks side effects with CC surgery, which could include bleeding, swelling, or infection during or after the procedure. This rarely happens, but if complications do arise, the results may be serious. It is important to discuss potential complications with your neurosurgeon prior to the surgery.
Other possible complications of corpus callosotomy include mutism (lack of speech), weakness of an extremity, or lack of bladder control. These seldom occur, and usually resolve within two weeks. Some children demonstrate a change in behavior. Neuropsychological testing may demonstrate other subtle deficits that are not functionally apparent. If your doctor thinks your child is at risk for these problems, he or she will discuss them with you in greater detail.