title: Robotic-arm stereotactic radiosurgery as a definitive treatment for gelastic epilepsy associated with hypothalamic hamartoma.
abstract: Gelastic seizures, characterised by paroxysms of pathological laughter, are most often associated with an underlying hypothalamic hamartoma. This report describes the definitive treatment using stereotactic-radiosurgery for a teenaged child whose gelastic epilepsy was found refractory to various antiepileptic drugs. Since surgery was not consented to, the child was referred to us for stereotactic radiosurgery (SRS), which was delivered with robotic-arm -SRS to a dose of 30 Gy in five fractions in five consecutive days. A decrease in the frequency of seizures was noticeable as early as within a week, and at 12 months after the procedure, there has been a total cessation of seizures.
authors.affiliation: Department of Radiation Oncology, HealthCare Global-Bangalore Institute of Oncology, Bengaluru, Karnataka, India.
authors.forename: Sridhar Papaiah
authors.initials: SP
authors.lastname: Susheela
authors.forename: Swaroop
authors.initials: S
authors.lastname: Revannasiddaiah
authors.forename: Govindarajan J
authors.initials: GJ
authors.lastname: Mallarajapatna
authors.forename: Ajaikumar
authors.initials: A
authors.lastname: Basavalingaiah
mesh_terms: D000293:Adolescent; D019583:Dose Fractionation, Radiation; D004828:Epilepsies, Partial / Q000209:etiology / Q000601:surgery*; D006222:Hamartoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D016634:Radiosurgery / Q000295:instrumentation*; D012371:Robotics; D016896:Treatment Outcome
references.citation: Brain. 2011 Oct;134(Pt 10):2960-8
references.pmid: 21975589
references.citation: Epileptic Disord. 2006 Sep;8(3):209-12
references.pmid: 16987743
references.citation: Brain. 1956 Dec;79(4):589-609
references.pmid: 13396065
references.citation: Epilepsia. 2008 May;49(5):861-71
references.pmid: 18076645
references.citation: Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e503-9
references.pmid: 21665381
references.citation: Neurology. 2002 May 14;58(9):1338-47
references.pmid: 12011278
references.citation: J Neurosurg. 1998 Oct;89(4):645-8
references.pmid: 9761061
references.citation: J Neurosurg. 2000 Apr;92(4):726-31
references.pmid: 10761669
references.citation: Epilepsia. 2010 Oct;51(10):2116-23
references.pmid: 20738381
references.citation: Rev Neurol (Paris). 1969 Mar;120(3):177-94
references.pmid: 4981043
references.citation: No Shinkei Geka. 2008 Mar;36(3):225-32
references.pmid: 18341011
references.citation: Acta Neurochir Suppl. 2002;84:57-63
references.pmid: 12379005
references.citation: Stereotact Funct Neurosurg. 2006;84(2-3):82-7
references.pmid: 16790990
references.citation: Ann Neurol. 1988 May;23(5):429-39
references.pmid: 3389755
references.citation: Epilepsy Curr. 2012 Mar;12(2):59-60
references.pmid: 22473543
references.citation: Exp Neurol. 2008 Oct;213(2):397-404
references.pmid: 18675803
references.citation: Electroencephalogr Clin Neurophysiol. 1995 Sep;95(3):154-60
references.pmid: 7555906
references.citation: J Neurosurg. 1999 Nov;91(5):881-4
references.pmid: 10541251
references.citation: Seizure. 2005 Jun;14(4):232-9
references.pmid: 15911357
references.citation: Neurosurg Focus. 2008;24(5):E9
references.pmid: 18447748
references.citation: Ann Neurol. 2005 Sep;58(3):371-82
references.pmid: 16130091
references.citation: Brain. 1993 Aug;116 ( Pt 4):757-80
references.pmid: 8353707
references.citation: Childs Nerv Syst. 2006 Aug;22(8):881-95
references.pmid: 16807727
references.citation: Strahlenther Onkol. 1999 Feb;175(2):47-56
references.pmid: 10065138
references.citation: Semin Pediatr Neurol. 2007 Jun;14(2):80-7
references.pmid: 17544951