A special brain surgery performed for fit (Corpus Callosotomy) - shall we talk about this?

Do you or someone in your family have a condition that causes seizures, that is, epilepsy? Sometimes, even with the medication prescribed by the doctor, it is very difficult to control this condition. Especially, if things like 'drop attacks' occur, where the body suddenly loses consciousness and falls to the ground, it is really dangerous. Today, we are talking about a special surgery that doctors recommend for such people.

What is Corpus Callosotomy?

Simply put, Corpus Callosotomy is a surgical procedure for epilepsy. It is usually performed on people with severe epilepsy that is difficult to control with medication.

Imagine that our brain is divided into two parts. We call these two parts hemispheres. These two hemispheres are connected to each other and exchange information through a nerve fiber that is like a bridge. That nerve fiber is called the Corpus Callosum .

During Corpus Callosotomy surgery, a specialist neurosurgeon performs a delicate operation through this bridge called the Corpus Callosum and cuts it.

What exactly does this surgery involve and who is it best suited for?

After this surgery, since the communication between the two sides of the brain is stopped, even if a fit does occur, it will be limited to one side of the brain. Therefore, the severity of the fit is greatly reduced.

This surgery is especially useful for people with atonic seizures . This is when the muscles in the body suddenly lose power without warning and they fall to the ground. We also call these 'drop attacks'. During these times, there is a high risk of breaking bones and hitting the head hard, causing serious injuries (concussions). So this surgery can make a big difference in the life of someone with such a dangerous type of seizure.

However, this surgery is not very useful for people who have partial/focal seizures, which start in one small area of ​​the brain and are limited to that area. This is because the seizure usually does not spread to other parts of the brain.

What to expect before surgery?

Your doctor will explain everything you need to know before the surgery. He or she will need to do some tests to find out exactly where in the brain the seizure is starting.

How is the surgery performed?

This surgery is performed under general anesthesia, which means you won't feel anything and will be completely asleep. The neurosurgeon will first make an opening in your skull (craniotomy).

The steps during the surgery are simply as follows:

• A small piece of bone is removed from the skull to make room for the surgery.
• The strong membrane called the 'dura' that protects the brain is slowly removed to reach the brain.
• Using special surgical instruments and a microscope, the nerve bundle called the Corpus Callosum is located and a fine incision is made through it.
• Then, the dura mater is put back in place, the removed skull bone is reattached, and the incision is closed with stitches or staples.

Sometimes, this surgery can be done in two stages . In the first stage, the doctor cuts only the front part of the Corpus Callosum. This allows the two sides of the brain to continue to exchange things like visual information.

However, if the severity of the fit does not decrease after that, the doctor may decide to perform a second surgery to completely separate the Corpus Callosum.

What can you expect after surgery?

You will need to stay in the hospital for a few days after surgery. You can usually return to your daily activities within 6 to 8 weeks. However, some people may take longer to recover. This depends on many factors, such as the nature of the surgery and any side effects that may occur.

During recovery, you may temporarily experience the following:

• Feeling very tired
• Depression
• Headache
• Memory problems
• Nausea
• Numbness around the surgical incision
• Difficulty speaking

What are the risks and complications of this surgery?

As with any brain surgery, there are some risks. But your doctor will only recommend surgery if the benefits outweigh the risks. Serious complications are very rare.

• Disconnection Syndrome: This is the most common problem that can occur after surgery. Simply put, because the two sides of the brain are disconnected, the two sides of the body can start to work in conflict with each other. For example, the left hand may feel like it is interfering with what the right hand is doing.

• Other risks:
• Loss of body balance (Loss of coordination)
• Partial seizures, which occur on only one side of the brain, may increase.
• Speech problems: Conditions such as difficulty forming words (apraxia) and difficulty understanding and speaking (aphasia).
• Risk of stroke.
• Brain swelling.
• Hydrocephalus. This often requires another surgery to place a shunt.

How successful was the surgery?

Studies have shown that this is a very effective treatment for fits that cannot be controlled with medication.

• Nearly half (50%) of those who undergo this surgery experience a complete cessation of 'drop attacks'.
• After surgery, 1 in 5 people (about 20%) may stop having seizures altogether.

Living with a condition called epilepsy is not easy. It can be life-threatening and even life-threatening. If severe seizures, such as 'drop attacks', cannot be controlled with medication, your doctor may suggest this surgery. This can greatly improve your quality of life.

Corpus Callosotomy, fit, epilepsy, brain surgery, neurosurgery, atonic seizure, drop attack