John Libbey Eurotext




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
Free Article
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

Hypothalamic hamartoma causing gelastic seizures treated with stereotactic radiofrequency thermocoagulation