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Disconnection of the cerebral hemispheres

An alternative to hemispherectomy for the control of intractable seizures

Departments of Neurosurgery and Psychiatry, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, and the Department of Psychology and Social Science in Medicine, State University of New York at Stony Brook, New York.

A boy with intractable seizures that had progressed to about 30 a day underwent complete disconnection of the cerebral hemispheres in January 1972. Using microsurgical technique, we followed the path described by Bogen and Vogel requiring division of the corpus callosum from rostrum to splenium, the anterior commissure, one fornix, and hippocampal commissure. Postoperative recovery was complicated by aseptic meningitis, which was treated with dexamethasone and, later, by hydrocephalus, which was reduced by ventriculoperitoneal shunt. The patient improved rapidly and remains well. We believe that disconnection is a preferred alternative to hemispherectomy for control of intractable seizures arising from early damage to one cerebral hemisphere.

Received for publication June 30, 1975.

Dr. Wilson's address is Hitchcock Clinic, Hanover, NH 03755.

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