Surgical Disconnection of the Cerebral Hemispheres for Intractable Seizures

In one infant, aged 4 months, and three young children, aged 3,3, and 7 years, with life-threatening, intractable, epileptic seizures the major interhemispheric commissures and one fornix were surgically divided. In the three children whose seizures were primarily of unilateral hemispheric origin the procedure has been very effective for control of seizures during followup intervals of 1 to 2 1/2 years. The infant's seizures were probably of bilateral origin and were not influenced by surgery. Surgical disconnection of the cerebral hemispheres may have greater application than hemispherectomy because it is not restricted to children with a severe hemiplegia and hemianopia. There was no evidence that cerebral disconnection produced an added neurological deficit, but elaborate testing for subtle deficits resulting from interruption of the interhemispheric transfer of information was not possible.