Reinventing the corpus callosotomy

Surgical section of the corpus callosum is an old operation. It was first performed to treat epilepsy more than 75 years ago.1 Early procedures often consisted of a “total commissurotomy,” performed through a right frontoparietal craniotomy, with division of the entire corpus callosum, the ipsilateral fornix, the anterior commissure, and even the massa intermedia of the thalamus.2 Subsequently, surgery has been limited to the corpus callosum, typically with sectioning of the anterior two-thirds (figure), sometimes followed by a second completion stage with a posterior transection if the first operation was ineffective.3,4