Historical review and surgical indication of corpus callosotomy for medically intractable epilepsies

Abstract

Corpus callosotomy for medically intractable epilepsies was initially performed to prevent secondarily seizure generalization through the corpus callosum in 1940, but surgical experiences indicated that this procedure was also effective for generalized epilepsies. Corpus callosotomy has been extensively used in the past 30 years. Results to date suggest that patients with secondarily generalized epilepsy with atonic, tonic, tonic-clonic seizure appear to respond well, while patients with complex partial seizures have less favorable results except for those with frontal lobe epilepsy. However, several issues remain controversial : the criteria of patient selection, the timing of the surgery, the extent of division, and the significance of postoperative EEG changes. We reviewed the developments of corpus callosotomy and its surgical indication, and discussed the seizure control mechanisms of the corpus callosum.