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Forebrain commissurotomy for epilepsy

Review of 20 consecutive cases

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Summary

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.

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References

  1. Akelaitis, A. J., A study of gnosis, praxis, and language following section of the corpus callosum and anterior commissure. J. Neurosurg.1 (1944), 94–102.

    Google Scholar 

  2. Bogen, J. E., Fisher, E. D., Vogel, P. J., Cerebral commissurotomy a second case report. J.A.M.A.194 (1965), 160–161.

    Google Scholar 

  3. Bogen, J. E., Sperry, R. W., Vogel, P. J., Commissural section and propagation of seizures. In: Basic mechanisms of the epilepsies (Jasper, H. H., Ward, A. A., Pope, A., eds.), pp. 439–440. Boston: Little, Brown. 1969.

    Google Scholar 

  4. Bogen, J. E., Vogel, P. J., Cerebral commissurotomy in man. Bull. Los Angeles Neurol. Soc.27 (1965), 169–172.

    Google Scholar 

  5. Crandall, P. H., Postoperative management and criteria for evaluation. In: Neurosurgical management of the epilepsies. Advances in neurology, Vol. 8 (Purpura, D. P., Penry, J. K., Walter, R. D., eds.), pp. 265–279. New York: Raven Press. 1975.

    Google Scholar 

  6. Erickson, T. C., Spread of the epileptic discharge: an experimental study of after discharge induced by electrical stimulation of cerebral cortex. Arch. Neurol. Psychiat.43 (1940), 429–452.

    Google Scholar 

  7. Gazzaniga, M. S., le Doux, J., The integrated mind. New York: Plenum Press. 1978.

    Google Scholar 

  8. Gazzaniga, M. S., le Doux, J. E., Wilson, D. H., Language, praxis and the right hemisphere: clues to some mechanisms of consciousness. Neurology (Minneap.)27 (1977), 1144–1147.

    Google Scholar 

  9. Gazzaniga, M. S., Risse, G. L., Springer, S. P., Clark, E., Wilson, D. H., Psychologic and neurologic consequences of partial and complete cerebral commissurotomy. Neurology (Minneap.)25 (1975), 10–17.

    Google Scholar 

  10. Geschwind, N., Disconnexion syndromes in animals and man. Brain88 (1965), 237–294 and 585–644.

    PubMed  Google Scholar 

  11. Gordon, H. W., Bogen, J. E., Sperry, R. W., Absence of deconnexion syndrome in two patients with partial section of the neocommissures. Brain94 (1973), 327–336.

    Google Scholar 

  12. Harbaugh, R. E., Wilson, D. H., Telencephalic theory of generalized epilepsy: observations in split-brain patients. Neurosurgery10 (1982), 725–732.

    PubMed  Google Scholar 

  13. Horsley, V., Abstract of the Brown lectures. Epilepsy lectures III–V. Lancet2 (1886), 1211–1213.

    Google Scholar 

  14. Le Doux, J. E., Risse, G. L., Springer, S. P., Wilson, D. H., Gazzaniga, M. S., Cognition and commissurotomy. Brain100 (1977), 87–104.

    PubMed  Google Scholar 

  15. Luessenhop, A. L., Interhemispheric commissurotomy as an alternative to hemispherectomy for control of intractable seizures. Am. Surg.36 (1970), 265–268.

    PubMed  Google Scholar 

  16. Luessenhop, A. J., de la Cruz, T. C., Fernichel, G. M., Surgical disconnection of the cerebral hemispheres for intractable seizures. J.A.M.A.213 (1970), 1620–1636.

    Google Scholar 

  17. Marcus, E. M., Watson, C. W., Bilateral synchronous electrographic patterns in the cat: interaction of bilateral cortical foci in the intact, the bilateral cortical-callosal and adiencephalic preparation. Arch. Neurol.14 (1966), 601–610.

    PubMed  Google Scholar 

  18. Marcus, E. M., Watson, C. W., Bilateral symmetrical epileptogenic foci in monkey cerebral cortex. Arch. Neurol.19 (1968), 99–116.

    PubMed  Google Scholar 

  19. Naquet, R., Menini, C., Catier, J., Photically induced epilepsy inPapio papio. The initiation of discharges and the role of the frontal cortex and of the corpus callosum. In: Synchronization of EEG activity in epilepsies (Petsche, H., Brazier, M. A. B., eds.), pp. 347–367. Wien-New York: Springer. 1972.

    Google Scholar 

  20. Sperry, R. W., Gazzaniga, M. S., Bogen, J. E., Interhemispheric relationships: the neocortical commissures; syndromes of hemisphere disconnection. In: Handbook of clinical neurology, Vol. 4 (Vinken, P. J., Bruyn, G. W., eds.), pp. 273–290. Amsterdam: North Holland Publishing Company. 1969.

    Google Scholar 

  21. Torres, F., French, L. A., Acute effect of section of the corpus callosum upon “independent” epileptiform activity. Acta Neurol. Scand.49 (1973), 47–62.

    PubMed  Google Scholar 

  22. Udvarhelyi, G. B., Walker, A. E., Dissemination of acute focal seizures in the monkey. I. From cortical foci. Arch. Neurol.12 (1965), 333–356.

    PubMed  Google Scholar 

  23. Van Wagenen, W. P., Herren, R. Y., Surgical division of commissural path-ways in the corpus callosum. Arch. Neurol.44 (1940), 740–759.

    Google Scholar 

  24. Walker, A. E., Udvarhelyi, G. B., The generalization of a seizure. J. Nerv. Ment. Dis.140 (1965), 252–271.

    PubMed  Google Scholar 

  25. Wilson, D. H., Limited exposure in cerebral surgery. J. Neurosurg.34 (1971), 102–106.

    PubMed  Google Scholar 

  26. Wilson, D. H., Culver, C., Waddington, M., Gazzaniga, M., Disconnection of the cerebral hemispheres. An alternative to hemispherectomy for the control of intractable seizures. Neurol.25 (1975), 1149–1153.

    Google Scholar 

  27. Wilson, D. H., Reeves, A., Gazzaniga, M., Division of the corpus callosum for uncontrollable epilepsy. Neurol.28 (1978), 649–653.

    Google Scholar 

  28. Wilson, D. H., Reeves, A., Gazzaniga, M., Corpus callosotomy for control of intractable seizures. In: Advances in epileptology: the tenth epilepsy international symposium (Wada, J. A., Penry, J. K., eds.), pp. 205–213. New York: Raven Press. 1980.

    Google Scholar 

  29. Wilson, D. H., Reeves, A., Gazzaniga, M., Culver, C., Cerebral commissurotomy for control of intractable seizures. Neurol.27 (1977), 708–715.

    Google Scholar 

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Harbaugh, R.E., Wilson, D.H., Reeves, A.G. et al. Forebrain commissurotomy for epilepsy. Acta neurochir 68, 263–275 (1983). https://doi.org/10.1007/BF01401184

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