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Results of anterior corpus callosum section in 24 patients with medically intractable seizures

Divisions of Neurological Science, Neurology, Neurosurgery, and Radiology, University of British Columbia, Vancouver, and the Department of Psychology, University of Victoria, Victoria, BC, Canada.

Twenty-four medically refractory seizure patients, who did not qualify for excisional surgery, had anterior two-thirds corpus callosum section. Three to 11 years' postoperative follow-up suggests that this procedure can (1) lateralize a frontal lobe focus, which may lead to subsequent localized excision and (2) significantly reduce seizure frequency and severity in 75% of the patients without giving any permanent neurologic deficits. Patients with an ictal focus confined to one frontal lobe did best (8/8 improved), followed by patients with secondarily generalized seizures and multifocal bilateral foci (5/6 improved). Patients with mental retardation benefited less frequently (5/10 improved), but 4/4 from this group with ictal falls associated with Lennox-Gastaut syndrome did benefit. In this series, the improvements following the anterior partial section were lasting if present at 1 year of follow-up. Anterior corpus callosum section should be considered as a diagnostic (lateralizing) and therapeutic option in appropriately defined medically refractory patients who do not qualify for excisional surgery.

Address correspondence and reprint requests to Dr. Wada, Division of Neurosciences and Neurology, Health Sciences Center Hospital, University of British Columbia, Vancouver, BC, Canada V6T 2A1.

Presented in part at the Joint 40th American Epilepsy and American EEG Meeting in Seattle, November 1985. Received July 22, 1987. Accepted for publication in final form December 23, 1987.

Supported by grants to J.A. Wada from the Medical Research Council of Canada, the Woodward Foundation, the Vancouver Society for Epilepsy Research, and the Vancouver Foundation and the Medical Research Council of Canada to E. Strauss.

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