Surgery for epilepsy. Selective partial microsurgical callosotomy for intractable multiform seizures: criteria for clinical selection and results

A series of 35 patients have been submitted to microsurgical callosotomy since February 1978, their age ranging from 6 to 42 years. The surgical procedure consisted either of a frontal parasagittal trephination or a larger frontoparietal rectangular craniotomy to allow the investigation of the surgical areas of the hemispheres with electrocorticography under local anesthesia. This allowed us to better follow the electrographic abnormalities and plan the extent of the callosal section suited to each case, in particular rostral and genual section, section of the trunk only or subtotal section sparing the splenium. In 2 cases, cortical resection was associated with the split. The callosal fibers which were divided by careful section under the resected portion provided a critical postoperative control of the extent of the lesion. Results and selection criteria will also be analyzed.