Forebrain commissurotomy for epilepsy. Review of 20 consecutive cases

During the past 10 years, 20 patients with intractable generalized, generalized and partial, and partial seizures have been treated here by surgical division of one or more of the forebrain commissures. Modifications in the operative technique and extent of operation have resulted in continued good results in seizure control with decreased morbidity. The present operation, a two-stage division of the corpus callosum and underlying hippocampal commissure, is demonstrated to be effective in controlling intractable seizures. Good or excellent results account for more than 80 per cent of the series. Historical background, indications for operation, criteria for patient selection, operative technique, results, complications, and the value of forebrain commissurotomy as a research tool are presented.