Hypothalamic hamartoma causing gelastic seizures treated with stereotactic radiofrequency thermocoagulation.
OBJECTIVE
To present a case of small hypothalamic hamartoma (HH) causing gelastic seizures and treated with stereotactic radiofrequency thermocoagulation.


METHODS
A 22-year-old man presented with intractable gelastic seizures and focal seizures refractory to medical treatment. Magnetic resonance imaging showed a 6 mm x 6 mm x 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.


CONCLUSIONS
Stereotactic radiofrequency thermocoagulation may be an effective and safe treatment option in selected cases of hypothalamic hamartoma with gelastic seizures.
Wang
Wei
W
Neurosurgery Institute of Guangdong, Southern Medical University, Beijing, China. gzwangwm@163.com
Wang
Weimin
W
Guo
Xiaofei
X
Zeng
Yanjun
Y
Jiang
Xiaodan
X
D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006222:Hamartoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D016634:Radiosurgery; D055815:Young Adult