Corpus callosotomy

"Callosotomy" redirects here. Not to be confused with Colostomy.

Corpus callosum

A corpus callosotomy (/kəˈlɔːs(ə)təmiː/) is a palliative surgical procedure for the treatment of medically refractory epilepsy.[1] The procedure was first performed in 1940 by William P. van Wagenen.[2] In this procedure, the corpus callosum is cut through, in an effort to limit the spread of epileptic activity between the two halves of the brain.[1] Another method to treat epilepsy is vagus nerve stimulation.[3]

Although the corpus callosum is the largest white matter tract connecting the hemispheres, some limited interhemispheric communication is still possible via the anterior and posterior commissures.[4] After the operation, however, the brain often struggles to send messages between hemispheres, which can lead to side effects such as speech irregularities, disconnection syndrome, and alien hand syndrome.

History

The first instances of corpus callosotomy were performed in the 1940s by William P. van Wagenen, who co-founded and served as president of the American Association of Neurological Surgeons. Attempting to treat epilepsy, van Wagenen studied and published the results of his surgeries, including the split-brain outcomes for patients. Most of the surgeries involved a partial division of the corpus callosum and resulted in improvements of seizure control in all patients.[2] Wagenen's work preceded the 1981 Nobel Prize-winning research of Roger W. Sperry by two decades. Sperry studied patients who had undergone corpus callosotomy and detailed their resulting split-brain characteristics.[2]

Improvements to surgical techniques, along with refinements of the indications, have allowed van Wagenen's procedure to endure; corpus callosotomy is still commonly performed throughout the world.[5] The surgery is a palliative treatment method for many forms of epilepsy, including atonic seizures, generalized seizures, and Lennox-Gastaut syndrome.[6] In a 2011 study of children with intractable epilepsy accompanied by attention deficit disorder, EEG showed an improvement to both seizures and attention impairments following corpus callosotomy.[7]

Typical procedure

Prior to surgery, the patient's head must be partially or completely shaven. Once under general anesthesia, an incision will allow for a craniotomy to be performed. Then sectioning will occur between the two hemispheres of the brain. For a partial callosotomy, the anterior two-thirds of the corpus callosum are sectioned, and for a complete callosotomy, the posterior one-third is also sectioned. Afterward, the dura is closed and the portion of cranium is replaced. The scalp is then closed with sutures.[8] Endoscopic corpus callosotomy has been employed with blood loss minimized during the surgical procedure.[9]

Indications

Corpus callosotomy is intended to treat patients who have epilepsy and the resultant chronic seizures. The diminished life expectancy associated with epilepsy has been documented by population-based studies in Europe. In the UK and Sweden, the relative mortality rate of epileptic patients (patients whose epilepsy was not under control from medical or other surgical therapies and who continued to have the disease) increased two- and threefold, respectively. In the vast majority of cases, corpus callosotomy abolishes instance of seizures in the patient.[10]

Contraindications

Although it varies from patient to patient, a progressive neurological or medical disease might be an absolute or relative contraindication to corpus callosotomy. Intellectual disability is not a contraindication to corpus callosotomy. In a study of children with a severe intellectual disability, total callosotomy was performed with highly favorable results and insignificant morbidity.[11]

Neuroanatomical background

Corpus callosum anatomy and function

Main article: Anatomy of the corpus callosum

The corpus callosum is a fiber bundle of about 300 million fibers in the human brain that connects the two cerebral hemispheres. Its interhemispheric functions include the integration of perceptual, cognitive, learned, and volitional information.[12]

Role in epileptic seizures

The role of the corpus callosum in epilepsy is the interhemispheric transmission of epileptiform discharges. These discharges are generally bilaterally synchronous in preoperative patients. In addition to disrupting this synchrony, corpus callosotomy decreases the frequency and amplitude of the epileptiform discharges, suggesting the transhemispheric facilitation of seizure mechanisms.[13]

Drawbacks

Side effects

Further information: Split-brain

The most prominent non-surgical complications of corpus callosotomy relate to speech irregularities. For some patients, sectioning may be followed by a brief spell of mutism. A long-term side effect may be an inability to engage in spontaneous speech. In addition, the resultant split-brain prevents some patients from following verbal commands that require the use of their non-dominant hand.[14]

Disconnection syndrome is another well-known side effect of the surgery.[15] This occurs due to the brain's inability to transfer information between the hemispheres.[16] One characteristic symptom is the "crossed-avoiding reaction", which is observed when one hemisphere does not respond to visual or sensory (e.g., touch, pressure, or pain) stimuli presented to the opposite side.

For instance, when an object is shown in the patient's right visual field, the left hemisphere (typically language-dominant) processes this information, allowing the patient to name the object easily. However, if the same object is shown in the left visual field, the right hemisphere perceives it, but the information does not transfer to the left (verbal) hemisphere.[17] Consequently, while the patient cannot verbally identify the object, they are still able to select it with their left hand.[17]

Another complication is alien hand syndrome, in which the affected person's hand appears to take on a mind of its own.[18] In one described incident, the patient grabbed their throat with their left hand and struggled to remove, as they had no control over it.[19]

Cognitive impairments may also be seen.[20] Other symptoms may occur after the operation but generally go away on their own, such as scalp numbness, feeling tired or depressed, headaches, and difficulty speaking, remembering things, or finding words.[21]

Alternatives

Epilepsy is also treated by a less invasive process called vagus nerve stimulation. This method utilizes an electrode implanted around the left vagus nerve within the carotid sheath in order to send electrical impulses to the nucleus of the solitary tract.[3] However, corpus callosotomy has been proven to offer significantly better chances of seizure freedom compared with vagus nerve stimulation (58.0% versus 21.1% reduction in atonic seizures, respectively).[22]

References

  1. ^ a b Mathews, Marlon S.; Linskey, Mark E.; Binder, Devin K. (29 February 2008). "William P. van Wagenen and the first corpus callosotomies for epilepsy". Journal of Neurosurgery. 108 (3): 608–613. doi:10.3171/JNS/2008/108/3/0608. ISSN 0022-3085. PMID 18312112. S2CID 6007475.
  2. ^ a b c Mathews, Marlon S.; Linskey, Mark E.; Binder, Devin K. (2008). "William P. Van Wagenen and the first corpus callosotomies for epilepsy". Journal of Neurosurgery. 108 (3): 608–613. doi:10.3171/JNS/2008/108/3/0608. PMID 18312112. S2CID 6007475.
  3. ^ a b Abd-El-Barr, Muhammad M.; Joseph, Jacob R.; Schultz, Rebecca; Edmonds, Joseph L.; Wilfong, Angus A.; Yoshor, Daniel (2010). "Vagus nerve stimulation for drop attacks in a pediatric population". Epilepsy & Behavior. 19 (3): 394–9. doi:10.1016/j.yebeh.2010.06.044. PMID 20800554. S2CID 13346234.
  4. ^ Gazzaniga, M. S. (1 July 2000). "Cerebral specialization and interhemispheric communication: Does the corpus callosum enable the human condition?". Brain. 123 (7): 1293–1326. doi:10.1093/brain/123.7.1293. PMID 10869045.
  5. ^ Markosian, Christopher; Patel, Saarang; Kosach, Sviatoslav; Goodman, Robert R.; Tomycz, Luke D. (1 March 2022). "Corpus Callosotomy in the Modern Era: Origins, Efficacy, Technical Variations, Complications, and Indications". World Neurosurgery. 159: 146–155. doi:10.1016/j.wneu.2022.01.037. ISSN 1878-8750.
  6. ^ Schaller, Karl (2012). "Corpus Callosotomy: What is New and What is Relevant?". World Neurosurgery. 77 (2): 304–305. doi:10.1016/j.wneu.2011.07.026. PMID 22120324.
  7. ^ Yonekawa, Takahiro; Nakagawa, Eiji; Takeshita, Eri; et al. (2011). "Effect of corpus callosotomy on attention deficit and behavioral problems in pediatric patients with intractable epilepsy". Epilepsy & Behavior. 22 (4): 697–704. doi:10.1016/j.yebeh.2011.08.027. PMID 21978470. S2CID 34733721.
  8. ^ Reeves, Alexander G.; Roberts, David W., eds. (1995). Epilepsy and the Corpus Callosum. Vol. 2. New York: Plenum Press. ISBN 978-0-306-45134-8.[page needed]
  9. ^ Sood S, Marupudi NI, Asano E, Haridas A, Ham SD (2015). "Endoscopic corpus callosotomy and hemispherotomy". J Neurosurg Pediatr. 16 (6): 681–6. doi:10.3171/2015.5.PEDS1531. PMID 26407094.
  10. ^ Sperling, Michael R.; Feldman, Harold; Kinman, Judith; Liporace, Joyce D.; O'Connor, Michael J. (1999). "Seizure control and mortality in epilepsy". Annals of Neurology. 46 (1): 45–50. doi:10.1002/1531-8249(199907)46:1<45::AID-ANA8>3.0.CO;2-I. PMID 10401779. S2CID 20595932.
  11. ^ Asadi-Pooya, Ali A.; Sharan, Ashwini; Nei, Maromi; Sperling, Michael R. (2008). "Corpus callosotomy". Epilepsy & Behavior. 13 (2): 271–278. doi:10.1016/j.yebeh.2008.04.020. PMID 18539083. S2CID 19256444.
  12. ^ Hofer, Sabine; Frahm, Jens (2006). "Topography of the human corpus callosum revisited—Comprehensive fiber tractography using diffusion tensor magnetic resonance imaging". NeuroImage. 32 (3): 989–94. doi:10.1016/j.neuroimage.2006.05.044. PMID 16854598. S2CID 1164423.
  13. ^ Matsuo, Atsuko; Ono, Tomonori; Baba, Hiroshi; Ono, Kenji (2003). "Callosal role in generation of epileptiform discharges: Quantitative analysis of EEGs recorded in patients undergoing corpus callosotomy". Clinical Neurophysiology. 114 (11): 2165–71. doi:10.1016/S1388-2457(03)00234-7. PMID 14580615. S2CID 10604808.
  14. ^ Andersen, Birgit; Árogvi-Hansen, Bjarke; Kruse-Larsen, Christian; Dam, Mogens (1996). "Corpus callosotomy: Seizure and psychosocial outcome a 39-month follow-up of 20 patients". Epilepsy Research. 23 (1): 77–85. doi:10.1016/0920-1211(95)00052-6. PMID 8925805. S2CID 19538184.
  15. ^ Stigsdotter-Broman, Lina; Olsson, Ingrid; Flink, Roland; Rydenhag, Bertil; Malmgren, Kristina (February 2014). "Long-term follow-up after callosotomy—A prospective, population based, observational study". Epilepsia. 55 (2): 316–321. doi:10.1111/epi.12488. ISSN 0013-9580. PMC 4165268. PMID 24372273.
  16. ^ Lechevalier, B.; Andersson, J. C.; Morin, P. (1 May 1977). "Hemispheric disconnection syndrome with a "crossed avoiding" reaction in a case of Marchiafava-Bignami disease". Journal of Neurology, Neurosurgery & Psychiatry. 40 (5): 483–497. doi:10.1136/jnnp.40.5.483. ISSN 0022-3050. PMC 492724. PMID 894319.
  17. ^ a b de Haan, Edward H. F.; Corballis, Paul M.; Hillyard, Steven A.; Marzi, Carlo A.; Seth, Anil; Lamme, Victor A. F.; Volz, Lukas; Fabri, Mara; Schechter, Elizabeth; Bayne, Tim; Corballis, Michael; Pinto, Yair (2020). "Split-Brain: What We Know Now and Why This Is Important for Understanding Consciousness". Neuropsychology Review. 30 (2): 224–233. doi:10.1007/s11065-020-09439-3. ISSN 1040-7308. PMC 7305066. PMID 32399946.
  18. ^ Biran, Iftah; Giovannetti, Tania; Buxbaum, Laurel; Chatterjee, Anjan (1 June 2006). "The alien hand syndrome: What makes the alien hand alien?". Cognitive Neuropsychology. 23 (4): 563–582. CiteSeerX 10.1.1.537.6357. doi:10.1080/02643290500180282. ISSN 0264-3294. PMID 21049344. S2CID 15889976. The alien hand syndrome is a deeply puzzling phenomenon in which brain-damaged patients experience their limb performing seemingly purposeful acts without their intention. Furthermore, the limb may interfere with the actions of their normal limb.
  19. ^ Hassan, Anhar; Josephs, Keith A. (17 June 2016). "Alien Hand Syndrome". Current Neurology and Neuroscience Reports. 16 (8): 73. doi:10.1007/s11910-016-0676-z. ISSN 1534-6293. PMID 27315251.
  20. ^ Huang, Xiaoqin; Du, Xiangnan; Song, Haiqing; Zhang, Qian; Jia, Jianping; Xiao, Tianyi; Wu, Jian (15 November 2015). "Cognitive impairments associated with corpus callosum infarction: a ten cases study". International Journal of Clinical and Experimental Medicine. 8 (11): 21991–21998. PMC 4724017. PMID 26885171.
  21. ^ "Corpus Callosotomy – Treatments – For Patients – UR Neurosurgery – University of Rochester Medical Center". urmc.rochester.edu.
  22. ^ Rolston, John D.; Englot, Dario J.; Wang, Doris D.; Garcia, Paul A.; Chang, Edward F. (October 2015). "Corpus callosotomy versus vagus nerve stimulation for atonic seizures and drop attacks: A systematic review". Epilepsy & Behavior. 51: 13–17. doi:10.1016/j.yebeh.2015.06.001. PMC 5261864. PMID 26247311.

Further reading

Read other articles:

Estella Warren

Estella WarrenWarren saat syuting film Blue Seduction pada November 2008.LahirEstella Dawn Warren23 Desember 1978 (umur 45)Peterborough, Ontario, KanadaTempat tinggalLos Angeles, California, ASKebangsaanKanadaPendidikanSilverthorn Collegiate InstitutePekerjaan Aktris model perenang Tahun aktif2001–sekarangTinggi5 ft 9 in (1,75 m) Estella Dawn Warren (lahir 23 Desember 1978)[1] adalah seorang aktris, model fesyen dan mantan perenang asal Kanada. Pada masa ka...

 

Sant'Eusebio

Church in Rome, ItalySant'EusebioSt. Eusebius (in English)Sancti Eusebii (in Latin)FacadeClick on the map for a fullscreen view41°53′47″N 12°30′13″E / 41.896272°N 12.503718°E / 41.896272; 12.503718LocationPiazza Vittorio Emanuele II, RomeCountryItalyDenominationRoman CatholicTraditionRoman RiteHistoryStatusTitular churchDedicationEusebius of RomeArchitectureArchitectural typeChurchGroundbreaking12th centuryClergyCardinal protectorDaniel DiNardo Sant'Eusebio...

 

بوابة:كأس العالم

كأس العالم هي أهم مسابقة لرياضة كرة القدم تقام تحت إشراف الاتحاد الدولي لكرة القدم. وتقام بطولة كأس العالم كل أربع سنوات منذ عام 1930، ما عدا بطولتي عام 1942 و1946 اللتين ألغيتا بسبب الحرب العالمية الثانية. يشارك في النظام الحالي للبطولة 32 منتخبا وطنيا، منذ 1998، مقسمين على ثماني م...

Metroid

MetroidLogo seri MetroidGenreAction-adventurePengembangNintendo R&D1, Intelligent Systems, Retro Studios, Nintendo Software Technology, Team Ninja, Next Level Games, MercurySteamPenerbitNintendoPembuatSatoru OkadaGunpei YokoiHiroji KiyotakeYoshio SakamotoPlatformNintendo Entertainment System, Game Boy, Super NES, Game Boy Advance, GameCube, Nintendo DS, Wii, Nintendo 3DS, Nintendo SwitchRilis pertamaMetroid6 Agustus 1986Rilis terakhirMetroid: Samus Returns15 September 2017 Metroid adalah ...

 

China at the 2017 World Aquatics Championships

Sporting event delegationChina at the2017 World Aquatics ChampionshipsFlag of ChinaFINA codeCHNNational federationChinese Swimming AssociationWebsiteswimming.org.cnin Budapest, HungaryCompetitors93 in 5 sportsMedalsRanked 2nd Gold 12 Silver 12 Bronze 6 Total 30 World Aquatics Championships appearances197319751978198219861991199419982001200320052007200920112013201520172019202220232024 China is scheduled to compete at the 2017 World Aquatics Championships in Budapest, Hungary from 14 July to 3...

 

Ulrich Kleemann

German general during World War II Ulrich KleemannBorn23 March 1892Langensalza, Province of Saxony, Kingdom of Prussia, German EmpireDied1 January 1963 (1963-02) (aged 70)Oberursel, Hesse, West GermanyAllegiance German Empire Weimar Republic Nazi GermanyService/branch German ArmyYears of service1911–1945Rank General der PanzertruppeCommands heldSturm-Division Rhodos90th Light Infantry DivisionBattles/warsWorld War IIAwardsKnight's Cross of the Iron Cross w...

1984 United States Senate election in South Dakota

1984 United States Senate election in South Dakota ← 1978 November 6, 1984 1990 →   Nominee Larry Pressler George V. Cunningham Party Republican Democratic Popular vote 235,176 80,537 Percentage 74.49% 25.51% County results Pressler:      50-60%      60-70%      70-80%      80–90%      >90%Cunningham:      5...

 

PostmarketOS

Free and open-source operating system for smartphones, based on Alpine Linux postmarketOSDeveloperpostmarketOS open-source communityOS familyLinux (Unix-like)Working stateActiveSource modelOpen sourceInitial release26 May 2017; 6 years ago (2017-05-26)Latest release23.12 (The One We Asked The Community To Name)[1] / 18 December 2023; 4 months ago (2023-12-18)Repositorygitlab.com/postmarketOS Marketing targetOperating system replacement for Android a...

 

Puukko

Traditional Finnish outdoor universal knife This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed.Find sources: Puukko – news · newspapers · books · scholar · JSTOR (July 2019) (Learn how and when to remove this message) Traditional puukko with birch handle and full-length fuller A puukko (Finnish pronunciation: [ˈpuːkːo...

Parlamento del Regno Unito

Questa voce o sezione sull'argomento parlamenti non cita le fonti necessarie o quelle presenti sono insufficienti. Puoi migliorare questa voce aggiungendo citazioni da fonti attendibili secondo le linee guida sull'uso delle fonti. Coordinate: 51°29′57.5″N 0°07′29.1″W / 51.499306°N 0.12475°W51.499306; -0.12475Parlamento del Regno Unito Stato Regno Unito TipoBicamerale imperfetto Camere Camera dei comuni Camera dei lord Istituito1º gennaio 1801 Prede...

 

Militer Australia dalam konfrontasi Indonesia–Malaysia

Seorang tentara Australia memegang senapan mesin MAG58 saat bertugas jaga di Kalimantan pada tahun 1965 Konfrontasi Indonesia-Malaysia berlangsung pada tahun 1962 sampai 1966 antara negara-negara Persemakmuran Inggris dan Indonesia. Indonesia, di bawah Presiden Soekarno, berusaha untuk mencegah pembentukan Federasi Malaysia pada 1963, sementara Persemakmuran Inggris berusaha untuk mengamankan negara baru itu. Perang berlangsung terbatas, terutama di pulau Kalimantan, meskipun beberapa kali se...

 

Joachim Pierzyna

Joachim Pierzyna Nazionalità  Polonia Calcio Ruolo Difensore Termine carriera 1973 CarrieraGiovanili 19?? LKS Sieraków ŚląskiSquadre di club1 1959 Sparta Lubliniec? (?)1960-1965 Polonia Bytom20+ (?)1967-1968 St. Louis Stars49 (4)1968 Dallas Tornado7 (1)1969-1973 St. Louis Stars64 (3)Nazionale 1962 Polonia1 (0) 1 I due numeri indicano le presenze e le reti segnate, per le sole partite di campionato.Il simbolo → indica un trasferimento in prestito. Stat...

Pornography Victims Compensation Act

This article is part of a series aboutMitch McConnell Early life Political positions Electoral history U.S. Senator from Kentucky Pornography Victims Compensation Act McConnell v. FEC Military Commissions Act of 2006 Honest Leadership and Open Government Act Protect America Act of 2007 Hemp Farming Act of 2018 vte The Pornography Victims Compensation Act of 1991 was a bill, S. 983,[1] in the U.S. Congress. The sponsor in the Senate was Senator Mitch McConnell[2] with eight co...

 

Marrano

Informasi lebih lanjut: Anusim dan Converso Marrano: Seder rahasia di Spanyol pada masa inkuisisi, sebuah lukisan tahun 1892 karya Moshe Maimon Marrano adalah Yahudi Spanyol dan Portugis yang tinggal di Semenanjung Iberia yang berpindah agama atau dipaksa pindah ke agama Kristen pada Abad Pertengahan, namun masih mempraktekkan agama Yahudi secara diam-diam. Istilah marrano dipakai pada 1492 dalam Dekrit Alhambra, yang melarang praktek agama Yahudi di Spanyol dan mewajibkan seluruh Yahudi yang...

 

Maria Borges

Angolan model Maria BorgesBorges in 2018Born (1992-10-28) 28 October 1992 (age 31)Luanda, AngolaNationalityAngolanOccupationModelYears active2010–presentKnown forVictoria's Secret Fashion Show, 2013–17Children1Modeling informationHeight1.80 m (5 ft 11 in)[1]Hair colorBlack[1]Eye colorBrown[1]Agency IMG Models (Worldwide)[2][3] 20 Model Management (Cape Town) Mega Model Agency (Hamburg) Elite Model Management (Hong Kong)...

List of United States presidential firsts

This list lists achievements and distinctions of various presidents of the United States. It includes distinctions achieved in their earlier life and post-presidencies. Due to some confusion surrounding sovereignty of nations during presidential visits, only nations that were independent, sovereign, or recognized by the United States during the presidency are listed here as a precedent. George Washington (1789–1797) Further information: George Washington George Washington was awarded the C...

 

Daftar permintaan maaf yang dibuat oleh Paus Yohanes Paulus II

Artikel atau sebagian dari artikel ini mungkin diterjemahkan dari Daftar permintaan maaf yang dibuat oleh Paus Yohanes Paulus II di en.wikipedia.org. Isinya masih belum akurat, karena bagian yang diterjemahkan masih perlu diperhalus dan disempurnakan. Jika Anda menguasai bahasa aslinya, harap pertimbangkan untuk menelusuri referensinya dan menyempurnakan terjemahan ini. Anda juga dapat ikut bergotong royong pada ProyekWiki Perbaikan Terjemahan. (Pesan ini dapat dihapus jika terjemahan dirasa ...

 

Bedfordshire

County of England Ceremonial county in EnglandBedfordshireCeremonial countyDunstable DownsBedford, Wrest ParkLocation of Bedfordshire in EnglandCoordinates: 52°05′N 0°25′W / 52.083°N 0.417°W / 52.083; -0.417Sovereign stateUnited KingdomConstituent countryEnglandRegionEastEstablishedAncientTime zoneUTC+0 (GMT) • Summer (DST)UTC+1 (BST)UK ParliamentList of MPsPoliceBedfordshire PoliceLargest townLutonCeremonial countyLord LieutenantSusan Lou...

Asking Alexandria

Bài viết này cần thêm chú thích nguồn gốc để kiểm chứng thông tin. Mời bạn giúp hoàn thiện bài viết này bằng cách bổ sung chú thích tới các nguồn đáng tin cậy. Các nội dung không có nguồn có thể bị nghi ngờ và xóa bỏ. (tháng 12 năm 2009) Asking AlexandriaAsking Alexandria performing at Soundwave 2014 in Melbourne, AustraliaThông tin nghệ sĩNguyên quánYork, North Yorkshire, AnhThể loạiMetalcore, post-hardcore, heavy...

 

Ian Johnson (writer)

American journalist Ian JohnsonBorn27 July 1962Montreal, Quebec, CanadaEducationUniversity of Florida, Free University of BerlinOccupationJournalistWebsitewww.ian-johnson.com Ian Johnson (born July 27, 1962) is a Canadian-born American journalist known for his long-time reporting and a series of books on China and Germany. His Chinese name is Zhang Yan (張彦).[1] Johnson writes regularly for The New York Review of Books[2] and The New York Times,[3] and The Wall Stre...