title: Successful third surgery for a case of status gelasticus: lessons learned after nearly 200 cases of hypothalamic hamartoma surgical resection.
abstract: We report the case of a 3-year-old boy with status gelasticus symptomatic to a giant hypothalamic hamartoma despite two previous hypothalamic hamartoma surgeries using pterional approaches from each side. Following his third resection employing an endoscopic, transventricular approach, he has been seizure free for 6 months with significant cognitive, behavioral, and electroencephalographic improvement. This case reinforces the importance of surgery for a form of status epilepticus and in addition that repeat (three) surgeries can be successful, indeed life changing. The optimal surgical approaches and management plan for hypothalamic hamartoma surgery-including subtemporal, subfrontal, transcallosal, and endoscopic approaches-are discussed, including how these treatment decisions have evolved as a result of our large series experience.
authors.affiliation: Divisions of Pediatric Neurology Pediatric Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA. y2ng@chw.edu
authors.forename: Yu-Tze
authors.initials: YT
authors.lastname: Ng
authors.forename: Harold L
authors.initials: HL
authors.lastname: Rekate
mesh_terms: D002675:Child, Preschool; D006222:Hamartoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D012086:Reoperation; D012640:Seizures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome