The results of corpus callosotomy in 18 patients 16 years old and younger are reported from the Sections of Neurology and Neurosurgery, Dartmouth-Hitchcock Medical Center, Hanover, NH. A significant improvement with a decrease in seizure frequency of greater than 80% occurred in 83% of patients having generalized atonic, tonic, or tonic-clonic seizures. There was no postoperative deterioration in behavior, memory, or language function when the callosotomy was performed as a two stage procedure. Some patients had a very mild and transient hemiparesis that resolved in a few days but none developed persistent mutism, a reported complication in other series. Many generalized seizures were converted to focal seizures postoperatively. Partial seizures are usually not responsive. Patients with evidence of unilateral disease tend to have the best results from callosotomy while those with generalized infantile spasms, Lennox-Gastaut syndrome, or anoxic encephalopathy have less predictable results. Mental retardation is not a contraindication and improvement in control of the seizures may improve behavior and cognitive functioning. 
COMMENT:. Callosotomy may be considered in young patients with frequent generalized atonic, tonic, and tonic-clonic seizures. Early surgical intervention may prevent the adverse effects of frequent recurrent seizures and the possibility of kindling.