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 Printable version |
Hypothalamic hamartoma causing gelastic seizures treated with stereotactic radiofrequency thermocoagulation |
Epileptic Disorders. Volume 11, Number 4, 333-8, December 2009, Clinical commentary with video sequences
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Author(s) : Wei Wang, Weimin Wang, Xiaofei Guo, Yanjun Zeng, Xiaodan Jiang |
Summary : Purpose. To present a case of small hypothalamic hamartoma (HH) causing gelastic seizures and treated with stereotactic radiofrequency thermocoagulation. Case report. A 22-year-old man presented with intractable gelastic seizures and focal seizures refractory to medical treatment. Magnetic resonance imaging showed a 6 mm × 6 mm × 7 mm sessile intraventricular HH. Under local anesthesia, four intra-hamartoma lesions were made via stereotactic radiofrequency thermocoagulation using a depth electrode for recording and stimulation. Results. Transient central hyperthermia, hypertension, and tachycardia were observed during the coagulation procedure. Intra-hamartoma spikes and slow waves were identified on depth electrode recordings. No gelastic seizure was induced by deep stimulation. The patient was seizure-free during the 12-month follow up and no permanent surgical complications occurred. Conclusion. Stereotactic radiofrequency thermocoagulation may be an effective and safe treatment option in selected cases of hypothalamic hamartoma with gelastic seizures. |
Keywords : gelastic seizure, hypothalamic hamartoma, stereotactic radiofrequency thermocoagulation |
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