Endoscopic disconnection for hypothalamic hamartoma with intractable seizure: Report of four cases

Joong Uhn Choi, Kook Hee Yang, Tae Gon Kim, Jong Hee Chang, Jin Woo Chang, Byung In Lee, Dong Seok Kim

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48 Citations (Scopus)

Abstract

Although intractable epilepsy associated with hypothalamic hamartoma (HH) can be controlled by microsurgical resection of the lesion, excision of deep-seated lesions is often associated with morbidity and mortality. Endoscopic disconnection is less invasive and seems to be well suited for this indication. The authors discuss the role of endoscopic-assisted surgery in the management of HH-induced seizures. Four patients with HH-related intractable gelastic seizure underwent endoscopic disconnection surgery. Postoperatively, all patients exhibited improvement. Two patients became seizure free immediately after endoscopic disconnection surgery, one patient with a widespread seizure focus involving the motor strip continued to experience rare complex partial seizures but gelastic seizures ceased, and one experienced a reduced frequency of seizures but persistence of some generalized seizures. Three patients suffered postoperative disconnection-like syndrome, which continued 3 to 7 days and spontaneously disappeared. The authors advocate the endoscopic disconnection surgery as a safe and effective treatment for HH-related epilepsy by blocking the spread of epileptic discharges from the lesion.

Original languageEnglish
Pages (from-to)506-511
Number of pages6
JournalJournal of neurosurgery
Volume100
Issue number5 SUPPL.
Publication statusPublished - 2004 May

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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    Choi, J. U., Yang, K. H., Kim, T. G., Chang, J. H., Chang, J. W., Lee, B. I., & Kim, D. S. (2004). Endoscopic disconnection for hypothalamic hamartoma with intractable seizure: Report of four cases. Journal of neurosurgery, 100(5 SUPPL.), 506-511.