Transcallosal resection of hypothalamic hamartoma for gelastic epilepsy.
BACKGROUND
Hypothalamic hamartomas (HHs) are commonly associated with severe epilepsy resistant to anticonvulsant therapy. Historically, surgical resection of HHs resulted in considerable morbidity.


CONCLUSIONS
Two series of patients who successfully underwent resection using a transcallosal approach have now been published; we report the first UK experience of this technique in a series of five patients with HHs and gelastic epilepsy resistant to anticonvulsant therapy. Patients were assessed pre- and postoperatively for seizure activity, endocrine function, ophthalmology, and neurocognitive function. Two patients had precocious puberty and all had evidence of developmental delay and behavioral problems. Postoperatively, all children experienced at least a 50% reduction in seizure frequency with abolition of major seizure types; one child remains seizure-free. One child developed a mild postoperative right hemiparesis and one developed transient diabetes insipidus.


CONCLUSIONS
There were no adverse developmental effects of surgery. Transcallosal resection of HHs ameliorates resistant epilepsy syndromes associated with HH.
Andrew
M
M
Department of Paediatric Neurology, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK. moragandrew@hotmail.com
Parr
J R
JR
Stacey
R
R
Rosenfeld
J V
JV
Hart
Y
Y
Pretorius
P
P
Nijhawan
S
S
Zaiwalla
Z
Z
McShane
M A
MA
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003337:Corpus Callosum / Q000601:surgery; D004828:Epilepsies, Partial / Q000209:etiology / Q000601:surgery*; D006222:Hamartoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000601:surgery*; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D013238:Stereotaxic Techniques / Q000009:adverse effects; D020542:Third Ventricle / Q000601:surgery