Surgical treatment of hypothalamic hamartoma
- Author:
Young Seok Park
;
Yun Ho Lee
;
Kyu-Won Shim
;
Dong-Seok Kim
- Publication Type:Journal Article
- From:Neurology Asia
2010;15(Supplement 1):15-20
- CountryMalaysia
- Language:English
-
Abstract:
Hypothalamic hamartomas are often associated with early onset gelastic seizures, precocious puberty,
behavioral problem and suboptimal response to antiepiletptic drugs. Until now, four surgical options
have been reported to reduce seizure by >50%. Surgical excision have good seizure outcome but
postoperative complications were not infrequent, whether by pterional or transcallosal interforniceal
approach. Radiosurgery is noninvasive alternative to resective surgery but the effect usually does not
appear until several months later. Radiofrequency ablation is less invasive than surgical resection and
its effect is immediate, but lacks long term follow-up data. It also requires three dimensional analysis of
the lesion to enhance effi cacy and safety. As hypothalamic hamartoma is intrinsically epileptogenic and
epileptogenic discharges spread from the lesion, blocking the seizure propagation through endoscopic
disconnection is regarded as an effective and safer option. Surgical choice for a particular patient
should take into account the hamartoma’s size, location, surgeon’s preferences, possible complication
as well as the effect and risk of the various surgical methods. In the present review, open surgery,
endoscopic disconnection, radiosurgery and radiofrequency ablation are discussed.
- Full text:P020150902457150352511.pdf