Corpus callosotomy in children and the disconnection syndromes: a review

Objects Disconnection syndromes following corpus callosotomy represent complex and variably expressed groupings of signs and symptoms affecting motor control, spatial orientation, vision, hearing, and language. Little is known, however, about the functional topography of callosal fiber pathways. In addition, most published case reports and case series of corpus callosotomy seldom report neurological deficits. We sought to categorize these deficits based on surgical anatomy. Methods We comprehensively reviewed the literature and described, compiled, and tabulated the most common disconnection syndromes complicating corpus callosotomy. We depict the topography of the cerebral cortex and associated commissural fibers of the corpus callosum through illustrations and diffusion tensor imaging tractography. Conclusions Anatomical classification of disconnection syndromes will provide great value to neurosurgeons embarking on callosotomy, whether partial or complete. Such information will apply to procedures performed for epilepsy and to procedures where the corpus callosum is sectioned for access to lesions within the ventricular system.