title: Transendoscopic intraoperative recording of gelastic seizures from a hypothalamic hamartoma.
abstract: OBJECTIVE
  The differential diagnosis of hypothalamic masses in children includes hamartomas, which are associated with gelastic seizures and endocrine dysfunction. The purpose of this study was to utilize transendoscopic electroencephalography (EEG) recording at the time of tissue biopsy to further assist in diagnosis, determination of prognosis, and treatment planning.
  
  
  METHODS
  We present the case of an infant with gelastic seizures and a large hypothalamic mass lesion. Despite a clinical and radiographic presentation typical of hypothalamic hamartoma (HH), slight growth on serial imaging raised concern for a diagnosis of intrinsic neoplasm. Biopsy of the lesion was recommended.
  
  
  RESULTS
  Transventricular, endoscopic biopsy, was undertaken, with concurrent intraoperative, transendoscopic EEG recording using a standard epilepsy depth recording macroelectrode. Numerous electrographic seizures were recorded. Histopathology revealed a HH.
  
  
  CONCLUSIONS
  This is the first report of intraoperative macroelectrode recording of electrographic seizures transendoscopically from a HH. This technique may prove useful for diagnosis, prognosis and treatment planning, as well as to guide transendoscopic therapeutic interventions for HH.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Colin M
authors.initials: CM
authors.lastname: Roberts
authors.forename: Eric M
authors.initials: EM
authors.lastname: Thompson
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Selden
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods; D005260:Female; D006222:Hamartoma / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology* / Q000601:surgery; D007223:Infant; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D044583:Neuroendoscopy / Q000295:instrumentation / Q000379:methods*; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery