A Prospective study of corpus callosotomy for medically intractable epilepsy

Results of corpus callosotomy on ten patients with medically intractable epilepsy, done between 1991 and 1996 are reported. Mean age of the patients was 20.5 years and mean duration of seizures 9.5 years. They underwent neurological assessment, detailed EEG studies and neuropsychological evaluation to rule out a resectable seizure focus. Seven patients underwent anterior callosotomy and three, a two staged total callosotomy. Acute disconnection syndrome was observed in about 50 cases which resolved completely in 1-3 weeks. The outcome was excellent in three, good in three, moderate in three and poor in one after a mean follow up of 21 months. Best response was seen in generalized tonic clonic, absence, atonic and tonic seizures. Most patientshad definite improvement in the quality of life after surgery. Age of patient, age at onset of seizures, duration of seizures and degree of mental retardation had no correlation with the outcome. Total callosotomy was found to have much better outcome compared to partial section. We conclude that callosotomy has a definite place in the management of medically intractable epilepsy especially for some seizure types.