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http://dx.doi.org/10.3340/jkns.2017.0101.005

Endoscopic Treatment of Hypothalamic Hamartomas  

Shim, Kyu Won (Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science)
Park, Eun Kyung (Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science)
Kim, Dong-Seok (Department of Pediatric Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science)
Publication Information
Journal of Korean Neurosurgical Society / v.60, no.3, 2017 , pp. 294-300 More about this Journal
Abstract
Hypothalamic hamartoma (HH) is a benign indolent lesion despite the presentation of refractory epilepsy. Behavioral disturbances and endocrine problems are additional critical symptoms that arise along with HHs. Due to its nature of generating epileptiform discharge and spreading to cortical region, various management strategies have been proposed and combined. Surgical approaches with open craniotomy or endoscopy, stereotactic approaches with radiosurgery and gamma knife surgery or radiofrequency thermos-coagulation, and laser ablation have been introduced. Topographical dimension and the surgeon's preference are key factors for treatment modalities. Endoscopic disconnection has been one of the most favorable options performed in treating HHs. Here we discuss presurgical evaluation, patient selection, surgical procedures, and complications.
Keywords
Hypothalamic hamartoma; Epilepsy; Endoscope;
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1 Choi JU, Yang KH, Kim TG, Chang JH, Chang JW, Lee BI, et al. : Endoscopic disconnection for hypothalamic hamartoma with intractable seizure. Report of four cases. J Neurosurg 100 : 506-511, 2004
2 Coons SW, Rekate HL, Prenger EC, Wang N, Drees C, Ng YT, et al. : The histopathology of hypothalamic hamartomas: study of 57 cases. J Neuropathol Exp Neurol 66 : 131-141, 2007   DOI
3 Delalande O, Fohlen M : Disconnecting surgical treatment of hypothalamic hamartoma in children and adults with refractory epilepsy and proposal of a new classification. Neurol Med Chir (Tokyo) 43 : 61-68, 2003   DOI
4 DiFazio MP, Davis RG : Utility of early single photon emission computed tomography (SPECT) in neonatal gelastic epilepsy associated with hypothalamic hamartoma. J Child Neurol 15 : 414-417, 2000   DOI
5 Fohlen M, Lellouch A, Delalande O : Hypothalamic hamartoma with refractory epilepsy: surgical procedures and results in 18 patients. Epileptic Disord 5 : 267-273, 2003
6 Gascon GG, Lombroso CT : Epileptic (gelastic) laughter. Epilepsia 12 : 63-76, 1971   DOI
7 Gumpert J, Hansotia P, Upton A : Gelastic epilepsy. J Neurol Neurosurg Psychiatry 33 : 479-483, 1970   DOI
8 Kahane P, Ryvlin P, Hoffmann D, Minotti L, Benabid AL : From hypothalamic hamartoma to cortex: what can be learnt from depth recordings and stimulation? Epileptic Disord 5 : 205-217, 2003
9 Kameyama S, Masuda H, Murakami H : Ictogenesis and symptomatogenesis of gelastic seizures in hypothalamic hamartomas: an ictal SPECT study. Epilepsia 51 : 2270-2279, 2010   DOI
10 Khan S, Wright I, Javed S, Sharples P, Jardine P, Carter M, et al. : High frequency stimulation of the mamillothalamic tract for the treatment of resistant seizures associated with hypothalamic hamartoma. Epilepsia 50 : 1608-1611, 2009   DOI
11 Kim do Y, Fenoglio KA, Simeone TA, Coons SW, Wu J, Chang Y, et al. : GABAA receptor-mediated activation of L-type calcium channels induces neuronal excitation in surgically resected human hypothalamic hamartomas. Epilepsia 49 : 861-871, 2008   DOI
12 Kuzniecky R, Guthrie B, Mountz J, Bebin M, Faught E, Gilliam F, et al. : Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol 42 : 60-67, 1997   DOI
13 Likavec AM, Dickerman RD, Heiss JD, Liow K : Retrospective analysis of surgical treatment outcomes for gelastic seizures: a review of the literature. Seizure 9 : 204-207, 2000   DOI
14 Marras CE, Rizzi M, Villani F, Messina G, Deleo F, Cordella R, et al. : Deep brain stimulation for the treatment of drug-refractory epilepsy in a patient with a hypothalamic hamartoma. Case report. Neurosurg Focus 30 : E4, 2011
15 Munari C, Kahane P, Francione S, Hoffmann D, Tassi L, Cusmai R, et al. : Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol 95 : 154-160, 1995   DOI
16 Ng YT, Rekate HL, Prenger EC, Wang NC, Chung SS, Feiz-Erfan I, et al. : Endoscopic resection of hypothalamic hamartomas for refractory symptomatic epilepsy. Neurology 70 : 1543-1548, 2008   DOI
17 Pati S, Abla AA, Rekate HL, Ng YT : Repeat surgery for hypothalamic hamartoma in refractory epilepsy. Neurosurg Focus 30 : E3, 2011
18 Roberts CM, Thompson EM, Selden NR : Transendoscopic intraoperative recording of gelastic seizures from a hypothalamic hamartoma. Pediatr Neurosurg 47 : 147-151, 2011   DOI
19 Regis J, Bartolomei F, de Toffol B, Genton P, Kobayashi T, Mori Y, et al. : Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Neurosurgery 47 : 1343-1351; discussion 1351-1342, 2000   DOI
20 Rekate HL, Feiz-Erfan I, Ng YT, Gonzalez LF, Kerrigan JF : Endoscopic surgery for hypothalamic hamartomas causing medically refractory gelastic epilepsy. Childs Nerv Syst 22 : 874-880, 2006   DOI
21 Rolston JD, Chang EF : Stereotactic Laser Ablation for Hypothalamic Hamartoma. Neurosurg Clin N Am 27 : 59-67, 2016   DOI
22 Rosenfeld JV, Freeman JL, Harvey AS : Operative technique: the anterior transcallosal transseptal interforniceal approach to the third ventricle and resection of hypothalamic hamartomas. J Clin Neurosci 11 : 738-744, 2004   DOI
23 Shim KW, Chang JH, Park YG, Kim HD, Choi JU, Kim DS : Treatment modality for intractable epilepsy in hypothalamic hamartomatous lesions. Neurosurgery 62 : 847-856; discussion 856, 2008   DOI
24 Specchio N, Rizzi M, Trivisano M, Fusco L, Rebessi E, Cappelletti S, et al. : Acute intralesional recording in hypothalamic hamartoma: description of 4 cases. Acta Neurol Belg 115 : 233-239, 2015   DOI
25 Steinmetz PN, Wait SD, Lekovic GP, Rekate HL, Kerrigan JF : Firing behavior and network activity of single neurons in human epileptic hypothalamic hamartoma. Front Neurol 4 : 210, 2013
26 Arroyo S, Santamaria J, Sanmarti F, Lomena F, Catafau A, Casamitjana R, et al. : Ictal laughter associated with paroxysmal hypothalamopituitary dysfunction. Epilepsia 38 : 114-117, 1997   DOI
27 Striano S, Striano P, Cirillo S, Nocerino C, Bilo L, Meo R, et al. : Small hypothalamic hamartomas and gelastic seizures. Epileptic Disord 4 : 129-133, 2002
28 Troester M, Haine-Schlagel R, Ng YT, Chapman K, Chung S, Drees C, et al. : EEG and video-EEG seizure monitoring has limited utility in patients with hypothalamic hamartoma and epilepsy. Epilepsia 52 : 1137-1143, 2011   DOI
29 Rekate HL : Management of hypothalamic hamartomas: progress due to alignment of the stars. Neurosurg Focus 30 : Introduction, 2011
30 Arita K, Ikawa F, Kurisu K, Sumida M, Harada K, Uozumi T, et al. : The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. J Neurosurg 91 : 212-220, 1999   DOI
31 Beggs J, Nakada S, Fenoglio K, Wu J, Coons S, Kerrigan JF : Hypothalamic hamartomas associated with epilepsy: ultrastructural features. J Neuropathol Exp Neurol 67 : 657-668, 2008   DOI
32 Berkovic SF, Arzimanoglou A, Kuzniecky R, Harvey AS, Palmini A, Andermann F : Hypothalamic hamartoma and seizures: a treatable epileptic encephalopathy. Epilepsia 44 : 969-973, 2003   DOI
33 Boyko OB, Curnes JT, Oakes WJ, Burger PC: Hamartomas of the tuber cinereum : CT, MR, and pathologic findings. AJNR Am J Neuroradiol 12 : 309-314, 1991
34 Cerullo A, Tinuper P, Provini F, Contin M, Rosati A, Marini C, et al. : Autonomic and hormonal ictal changes in gelastic seizures from hypothalamic hamartomas. Electroencephalogr Clin Neurophysiol 107 : 317- 322, 1998   DOI
35 Wethe JV, Prigatano GP, Gray J, Chapple K, Rekate HL, Kerrigan JF : Cognitive functioning before and after surgical resection for hypothalamic hamartoma and epilepsy. Neurology 81 : 1044-1050, 2013   DOI
36 Usami K, Matsumoto R, Sawamoto N, Murakami H, Inouchi M, Fumuro T, et al. : Epileptic network of hypothalamic hamartoma: an EEG-fMRI study. Epilepsy Res 125 : 1-9, 2016   DOI
37 Valdueza JM, Cristante L, Dammann O, Bentele K, Vortmeyer A, Saeger W, et al. : Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery 34 : 949-958; discussion 958, 1994
38 Wait SD, Abla AA, Killory BD, Nakaji P, Rekate HL : Surgical approaches to hypothalamic hamartomas. Neurosurg Focus 30 : E2, 2011
39 Wu J, Xu L, Kim DY, Rho JM, St John PA, Lue LF, et al. : Electrophysiological properties of human hypothalamic hamartomas. Ann Neurol 58 : 371-382, 2005   DOI
40 Choi JU, Kim DS : Treatment Modalities for Intractable Epilepsy in Hypothalamic Hamartoma, in Schramm J (ed): Advances and Technical Standards in Neurosurgery. Wien : Springer, 2012, Vol 39, pp118-130