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In August of 1991, a second Dartmouth International Workshop on the
corpus callosum was convened to share and discuss the progress that
had been made over the decade that had passed following the first
workshop. A nucleus of basic and clinical scientists came together
to discuss their work and the work of others in a field that has
been broadened clinically by the addition of many new centers
throughout the world that are now performing corpus callosotomy for
intractable epilepsy. This text was stimulated by the participants'
presentations and associated fertile discussions. It is compiled
from the conference and subsequent studies. It reflects, both at
the basic and clinical level, an important and expanding field of
neural science endeavor. In keeping with the present and rapidly
expanding field of outcomes assessment, callosotomy is again
evaluated in light of a further decade of surgery and follow-up.
Callosotomy continues to be a useful, palliative procedure and the
indications for its use have been better established. The basic
science section is a supplement to the first edition and elaborates
progress in both new data and ideas. The section on experimental
epilepsy models adds further support to the clinical rationale for
callosotomy. Perhaps of greater importance is the contribution of
experimental models to our understanding of the propagation of
seizure activity. The section on the neuropsychology of the split
brain patient demonstrates the continuing major contributions to
the understanding of brain and behavior that pour forth from this
cornucopia.
In August of 1991, a second Dartmouth International Workshop on the
corpus callosum was convened to share and discuss the progress that
had been made over the decade that had passed following the first
workshop. A nucleus of basic and clinical scientists came together
to discuss their work and the work of others in a field that has
been broadened clinically by the addition of many new centers
throughout the world that are now performing corpus callosotomy for
intractable epilepsy. This text was stimulated by the participants'
presentations and associated fertile discussions. It is compiled
from the conference and subsequent studies. It reflects, both at
the basic and clinical level, an important and expanding field of
neural science endeavor. In keeping with the present and rapidly
expanding field of outcomes assessment, callosotomy is again
evaluated in light of a further decade of surgery and follow-up.
Callosotomy continues to be a useful, palliative procedure and the
indications for its use have been better established. The basic
science section is a supplement to the first edition and elaborates
progress in both new data and ideas. The section on experimental
epilepsy models adds further support to the clinical rationale for
callosotomy. Perhaps of greater importance is the contribution of
experimental models to our understanding of the propagation of
seizure activity. The section on the neuropsychology of the split
brain patient demonstrates the continuing major contributions to
the understanding of brain and behavior that pour forth from this
cornucopia.
InJuly 1982 the first Dartmouth workshop on the corpus callosum
took place. A nucleus of basic and clinical scientists was convened
to give progress reports of their work on the corpus callosum. This
text was subsequently compiled by the various participants from
these reports modified by a stimulating cross fertilization of
ideas and subsequent studies. Four and one-half decades have
intervened since Van Wagenen first sectioned the corpus callosum
for epilepsy (Van Wagenen and Herren, 1940) and Erickson (1940)
demonstrated that the corpus callosum is the major route for
generalization of experimentally induced focal cortical epilepsy.
During the succeeding 45 years a handful of clinicians has pursued
these leads to confirm the therapeutic value of callosotomy for
some types of medically intractable generalized epilepsy. Parallel
experimental studies with a number of epilepsy models have
indicated that the corpus callosum is indeed the major route for
seizure generalization, that the brainstem is a secondary and more
resistant pathway for seizure generalization, and that most if not
all epileptic seizures originate from the cerbral cortex. The
unexpected clinical finding that even partial (focal) seizure
incidence is modified by callosotomy now has been demonstrated in
the laboratory. The various contributors to the clinical and
experimental epilepsy sections of this volume have been seminal in
these elucidations, as will be evident from their chapters. The
section on the development, anatomy, and physiology of the corpus
callosum demonstrates that these basic areas of study have not been
neglected.
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