Corpus Callosotomy for Epilepsy
What Is a Corpus Callosotomy?
Corpus callosotomy is a type of surgery that helps decrease the number and severity of seizures. It has been used to treat drop seizures, where a child may fall down during a seizure. More recently, doctors also use this surgery to treat other seizure types, such as generalized tonic or tonic-clonic seizures or epileptic spasms. During the surgery, the surgeon will cut the corpus callosum, or the connections between the two sides (hemispheres) of the brain, using a scalpel or laser.
The procedure does not sever all connections between the two hemispheres. It only affects the connections that allow seizures to spread between the hemispheres.
What Is the Corpus Callosum?
The corpus callosum is a large bundle of connections in the brain called white matter. These connections link groups of brain cells on either side of the brain, allowing information to pass between the hemispheres. However, this connection also makes it easier for seizures that start on one side of the brain to spread over the whole brain, making the seizures worse.
Who Is a Candidate for Corpus Callosotomy?
Every child’s epilepsy surgery journey is unique. The epilepsy team will review your child’s medical history, medical imaging, and tests at a surgical conference. The team might recommend corpus callosotomy if your child:
- Has daily or nearly daily seizures involving their whole body
- Has seizures that have not responded well to anti-seizure medications
- Cannot tolerate anti-seizure medications due to side effects
What Are the Benefits of Corpus Callosotomy?
The goal of this surgery is to make a child safer from seizures. This type of surgery is expected to help most children by slowing down the spread of seizures. It reduces big seizures (generalized tonic, tonic-clonic or atonic) in most children. Some children may have very few or no seizures after surgery, especially when used in combination with medicines or other surgeries.
While your child may experience subtle changes in certain abilities after the procedure, the surgery generally does not impact or change their daily life.
What Are the Risks of Corpus Callosotomy?
The corpus callosotomy surgery uses tools and techniques to maximize safety. However, as with all surgeries, there are still some risks. These include:
- Skin or brain infections
- Stroke or brain bleeding
- Fluid leaking from the brain
Children often have temporary weakness or clumsiness after surgery that improves over a few days or weeks. These are called types of disconnection syndromes. Disconnection syndromes will improve but may result in a longer hospital stay to receive physical, occupational, speech or other therapies.
The corpus callosum - a large bundle of connections in the brain called white matter - connects the left and right hemispheres of the brain.
Key: Right hemisphere (blue dot); Left hemisphere (orange dot); Corpus callosum (teal dots)
What Happens During Corpus Callosotomy?
Before surgery, the neurosurgeon will discuss the type of approach for the corpus callosotomy. They might suggest using a laser fiber approach or using a small incision (open) approach. The choice may depend on your child’s brain anatomy, age and other factors.
- Laser corpus callosotomy: Your child’s head will be placed in a rigid head holder after your child is under general anesthesia. The neurosurgeon will use a robot to help guide the placement of three to four holes in your child’s head. These holes will help the laser probe to pass into the corpus callosum. Your child will then be placed into the magnetic resonance imaging (MRI) machine inside the operating room. While the laser is on, the MRI will measure the temperature inside their head to make sure it is safe and that only the corpus callosum is treated with the laser. Afterward, the laser probes are removed, and the holes are closed. Your child will wake up in the recovery area after surgery.
- Open corpus callosotomy: An incision will be made near the top of your child’s head after your child is under general anesthesia. The neurosurgeon will make an opening in the skull and the covering around the brain. Then, they will gently move apart the two sides of the brain, or hemispheres, so the corpus callosum can be seen. The neurosurgeon will sever the corpus callosum from the front to the back and the opening will be closed. Your child will wake up in the recovery area after surgery.
What Happens After Corpus Callosotomy?
After the surgery, your child may stay in the PICU (Pediatric Intensive Care Unit) for a few days before being transferred to the Neurosurgery hospital floor. This part of the recovery usually lasts five to 10 days. If your child has a disconnection syndrome resulting in weakness, clumsiness or other problems, the Physical Medicine team and therapists will start helping them right after surgery. If they need more time to get better, they will be transferred to the Inpatient Rehabilitation Unit. When your child has recovered most of the way, they will go home and usually get more therapy as an outpatient. Your child will continue their anti-seizure medicines at the usual doses and see the Neurology doctor two to three months after surgery.
Medical Reviewer: Ammar Shaikhouni, MD, PhD, Nationwide Children's Hospital
Date Last Reviewed: 7/25/2025
The information provided here is only for general reference and should not take the place of medical care or patient education. If you have any questions, please call our Epilepsy Surgery Clinic at (614) 722-4625.
