Surgical treatment of epilepsy secondary to a hypothalamic hamartoma: a case report

Cover Page


Cite item

Full Text

Abstract

A hypothalamic hamartoma is a benign, congenital, heterotopic, neoplastic space-occupying mass located in the interpeduncular fossa, corresponding to a gangliocytoma according to the morphological classification. Patients with hypothalamic hamartoma often experience gelastic seizures and early puberty. Increasing evidence that hypothalamic hamartomas are the cause of gelastic seizures and secondary epileptogenesis has led to surgery being used more often as a permanent cure. Several minimally invasive procedures have been developed, including neuroendoscopic approaches and various stereotactic techniques in radiofrequency and laser ablation. Each method can lead to its own unique side effects. We conducted a review of the available Russian and international literature. This case report describes the surgical treatment of epilepsy secondary to a hypothalamic hamartoma.

About the authors

Irina G. Areshkina

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Author for correspondence.
Email: strotskaya1992@mail.ru
Россия, Krasnoyarsk

Diana V. Dmitrenko

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: strotskaya1992@mail.ru
Россия, Krasnoyarsk

Alexey I. Dmitrenko

Krasnoyarsk Interdistrict Clinical Emergency Hospital named after N.S. Karpovich

Email: strotskaya1992@mail.ru
Россия, Krasnoyarsk

Ekaterina A. Narodova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: strotskaya1992@mail.ru
Россия, Krasnoyarsk

References

  1. Osborn A.G. Diagnostic Neuroradiology. St. Louis; 1994.
  2. Nguyen D., Singh S., Zaatreh M. et al. Hypothalamic hamartomas: seven cases and review of the literature. Epilepsy Behav 2003; 4: 246–258. doi: 10.1016/s1525-5050(03)00086-6. PMID: 12791326.
  3. Susheela S.P., Revannasiddaiah S., Mallarajapatna G.J., Basavalingaiah A. Robotic-arm stereotactic radiosurgery as a definitive treatment for gelastic epilepsy associated with hypothalamic hamartoma. BMJ Case Rep 2013; 2013: bcr2013200538. doi: 10.1136/bcr-2013-200538. PMID: 24027254.
  4. Striano S., Santulli L., Ianniciello M. et al. The gelastic seizures-hypothalamic hamartoma syndrome: facts, hypotheses, and perspectives. Epilepsy Behav 2012; 24: 7–13. doi: 10.1016/j.yebeh.2012.02.013. PMID: 22503469.
  5. Cascino G.D., Andermann F., Berkovic S.F. et al. Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology 1993; 43: 747–750. doi: 10.1212/wnl.43.4.747. PMID: 8469334.
  6. List C.F., Dowman C.E., Bagchi B.K., Bebin J. Posterior hypothalamic hamartomas and gangliogliomas causing precocious puberty. Neurology 1958; 8: 164–174. doi: 10.1212/wnl.8.3.164. PMID: 13517481.
  7. Gascon G.G., Lombroso C.T. Epileptic (gelastic) laughter. Epilepsia 1971; 12: 63–76. doi: 10.1111/j.1528-1157.1971.tb03916.x. PMID: 5282883.
  8. Palmini A., Chandler C., Andermann F., Costa Da Costa J. et al. Resection of the lesion in patients with hypothalamic hamartoma and catastrophic epilepsy. Neurology 2002; 58: 1338–1347. doi: 10.1212/wnl.58.9.1338. PMID: 12011278.
  9. Arzimanoglou A.A., Hirsch E., Aicardi J. Hypothalamic hamartoma and epilepsy in children: illustrative cases of possible evolutions. Epileptic Disord 2003; 5: 187–199. PMID: 14975787.
  10. Scholly J., Staack A.M., Kahane P. et al. Hypothalamic hamartoma: epileptogenesis beyond the lesion? Epilepsia 2017; 58: 32–40. doi: 10.1111/epi.13755. PMID: 28591482.
  11. Killeen Z., Bunch R., Kerrigan J.F. Psychiatric comorbidity with hypothalamic hamartoma: systematic review for predictive clinical features. Epilepsy Behav 2017; 73: 126–130. doi: 10.1016/j.yebeh.2017.05.019. PMID: 28636978.
  12. Gosavi T.D., Walker M.C. A case of pure gelastic seizures due to hypothalamic hamartoma with a benign course. Epilepsy Behav Case Rep 2017; 8: 111–113. doi: 10.1016/j.ebcr.2017.06.004. PMID: 29085777.
  13. Arita K., Ikawa F., Kurisu K. et al. The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. J Neurosurg 1999; 91: 212–220. doi: 10.3171/jns.1999.91.2.0212. PMID: 10433309.
  14. Freeman J.L., Harvey A.S., Rosenfeld J.V. et al. Generalized epilepsy in hypothalamic hamartoma: evolution and postoperative resolution. Neurology 2003; 60: 762–767. doi: 10.1212/01.wnl.0000049457.05670.7d. PMID: 12629230.
  15. Castro L.H., Ferreira L.K., Teles L.R. et al. Epilepsy syndromes associated with hypothalamic hamartoma. Seizure 2007; 16: 50–58. doi: 10.1016/j.seizure.2006.10.008. PMID: 17157037.
  16. Kuzniecky R., Guthrie B., Mountz J. et al. Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol 1997; 42: 60–67. doi: 10.1002/ana.410420111. PMID: 9225686.
  17. Bajorek J.G., Lee R.J., Lomax P. Neuropeptides: a role as endogenous mediators or modulators of epileptic phenomena. Ann Neurol 1984; 16: 31–38. doi: 10.1002/ana.410160707. PMID: 6095740.
  18. Munari C., Kahane P., Francione S. et al. Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol 1995; 95: 154–160. doi: 10.1016/0013-4694(95)00063-5. PMID: 7555906.
  19. Freeman J.L., Coleman L.T., Wellard R.M. et al. MR imaging and spectroscopic study of epileptogenic hypothalamic hamartomas: analysis of 72 cases. AJNR Am J Neuroradiol 2004; 25: 450–462. PMID: 15037472.
  20. Troester M., Haine-Schlagel R., Ng Y.T. et al. EEG and video-EEG seizure monitoring has limited utility in patients with hypothalamic hamartoma and epilepsy. Epilepsia 2011; 52: 1137–1143. doi: 10.1111/j.1528-1167.2011.03095.x. PMID: 21569021.
  21. Mironov M.B., Ivanova I.V., Mukhin K.Yu. [Gelastic seizures]. Epilepsia i paroksizmal’nyye sostoyaniya 2014; 6(3): 20–29. (In Russ.)
  22. Mironov M.B., Mukhin K.Yu., Dorofeeva M.Yu. et al. [Gelastic seizures in tuberous sclerosis]. Russkiy zhurnal detskoy nevrologii 2014; 9 (2): 50–54. (In Russ.)
  23. Khawaja A.M., DeWolfe J.L., Miller D.W., Szaflarski J.P. New-onset refractory status epilepticus (NORSE)—the potential role for immunotherapy. Epilepsy Behav 2015; 47: 17–23. doi: 10.1016/j.yebeh.2015.04.054. PMID: 26010959.
  24. Khawaja A.M., Wang G., Cutter G.R., Szaflarski J.P. Continuous electroencephalography (cEEG) monitoring and outcomes of critically ill patients. Med Sci Monit 2017; 23: 649–658. doi: 10.12659/msm.900826. PMID: 28160596.
  25. Waldau B., McLendon R.E., Fuchs H.E. et al. Few isolated neurons in hypothalamic hamartomas may cause gelastic seizures. Pediatr Neurosurg 2009; 45: 225–229. doi: 10.1159/000224620. PMID: 19521137.
  26. Singh S., Garge S. Agenesis of the corpus callosum. J Pediatr Neurosci 2010; 5: 83–85. doi: 10.4103/1817-1745.66662. PMID: 21042520.
  27. Berkovic S.F., Arzimanoglou A., Kuzniecky R. et al. Hypothalamic hamartoma and seizures: a treatable epileptic encephalopathy. Epilepsia 2003; 44: 969–973. doi: 10.1046/j.1528-1157.2003.59102.x. PMID: 12823582.
  28. Mahachoklertwattana P., Kaplan S.L., Grumbach M.M. The luteinizing hormone-releasing hormone-secreting hypothalamic hamartoma is a congenital malformation: natural history. J Clin Endocrinol Metab 1993; 77: 118–124. doi: 10.1210/jcem.77.1.8325933. PMID: 8325933.
  29. Striano S., Meo R., Bilo L. et al. Gelastic epilepsy: symptomatic and cryptogenic cases. Epilepsia 1999; 40: 294–302. doi: 10.1111/j.1528-1157.1999.tb00707.x. PMID: 10080508.
  30. Arita K., Kurisu K., Iida K. et al. Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma. Case report. J Neurosurg 1998; 89: 645–648. doi: 10.3171/jns.1998.89.4.0645. PMID: 9761061.
  31. Likavec A.M., Dickerman R.D., Heiss J.D., Liow K. Retrospective analysis of surgical treatment outcomes for gelastic seizures: a review of the literature. Seizure 2000; 9: 204–207. doi: 10.1053/seiz.1999.0352. PMID: 10775517.
  32. Mathieu D., Kondziolka D., Niranjan A. et al. Gamma knife radiosurgery for refractory epilepsy caused by hypothalamic hamartomas. Stereotact Funct Neurosurg 2006; 84: 82–87. doi: 10.1159/000094036. PMID: 16790990.
  33. Freeman J.L., Harvey A.S., Rosenfeld J.V. et al. Generalized epilepsy in hypothalamic hamartoma: evolution and postoperative resolution. Neurology 2003; 60: 762–767. doi: 10.1212/01.wnl.0000049457.05670.7d. PMID: 12629230.
  34. Arroyo S., Lesser R.P., Gordon B. et al. Mirth, laughter and gelastic seizures. Brain 1993; 116: 757–780. doi: 10.1093/brain/116.4.757. PMID: 8353707.
  35. Frattali C.M., Liow K., Craig G.H. et al. Cognitive deficits in children with gelastic seizures and hypothalamic hamartoma. Neurology 2001; 57: 43–46. doi: 10.1212/wnl.57.1.43. PMID: 11445626.
  36. Khawaja A.M., Pati S., Ng Y.T. Management of epilepsy due to hypothalamic hamartomas Pediatr Neurol 2017; 75: 29–42. doi: 10.1016/j.pediatrneurol.2017.07.001. PMID: 28886982.
  37. Mottolese C., Stan H., Bret P. et al. Hypothalamic hamartoma: the role of surgery in a series of eight patients. Childs Nerv Syst 2001; 17: 229–238. doi: 10.1007/s003810000361. PMID: 11398942.
  38. Rosenfeld J.V. The evolution of treatment for hypothalamic hamartoma: a personal odyssey. Neurosurg Focus 2011; 30: E1. doi: 10.3171/2010.11.focus10244. PMID: 21374829.
  39. Ng Y.T., Rekate H.L., Prenger E.C. et al. Transcallosal resection of hypothalamic hamartoma for intractable epilepsy. Epilepsia 2006; 47: 1192–1202. doi: 10.1111/j.1528-1167.2006.00516.x. PMID: 16886983.
  40. Ng Y.T., Hastriter E.V., Wethe J. et al. Surgical resection of hypothalamic hamartomas for severe behavioral symptoms. Epilepsy Behav 2011; 20: 75–78. doi: 10.1016/j.yebeh.2010.10.027. PMID: 21130692.
  41. Drees C., Chapman K., Prenger E. et al. Seizure outcome and complications following hypothalamic hamartoma treatment in adults: endoscopic, open, and Gamma Knife procedures. J Neurosurg 2012; 117: 255–261. doi: 10.3171/2012.5.JNS112256. PMID: 22680243.
  42. Ng Y.T., Rekate H.L., Prenger E.C. et al. Endoscopic resection of hypothalamic hamartoma for refractory symptomatic epilepsy. Neurology 2008; 70: 1543–1548. doi: 10.1212/01.wnl.0000310644.40767.aa. PMID: 18427070.
  43. Dunoyer C., Ragheb J., Resnick T. et al. The use of stereotactic radiosurgery to treat intractable childhood partial epilepsy. Epilepsia 2002; 43: 292–300. doi: 10.1046/j.1528-1157.2002.06501.x. PMID: 11906515.
  44. Barajas M.A., Ramirez-Guzman M.G., Rodriguez-Vazquez C. et al. Gamma Knife surgery for hypothalamic hamartomas accompanied by medically intractable epilepsy and precocious puberty: experience in Mexico. J Neurosurg 2005; 102: 53–55. doi: 10.3171/jns.2005.102.s_supplement.0053. PMID: 15662781.
  45. Shim K.W., Chang J.H., Park Y.G. et al. Treatment modality for intractable epilepsy in hypothalamic hamartomatous lesions. Neurosurgery 2008; 62: 847–856. doi: 10.1227/01.neu.0000318170.82719.7c. PMID: 18496191.
  46. Regis J., Bartolomei F., Hayashi M., Chauvel P. Gamma Knife surgery, a neuromodulation therapy in epilepsy surgery! Acta Neurochir Suppl 2002; 84: 37–47. doi: 10.1007/978-3-7091-6117-3_4. PMID: 12379003.
  47. Regis J., Scavarda D., Tamura M. et al. Epilepsy related to hypothalamic hamartomas: surgical management with special reference to gamma knife surgery. Childs Nerv Syst 2006; 22: 881–895. doi: 10.1007/s00381-006-0139-y. PMID: 16807727.
  48. Regis J., Scavarda D., Tamura M. et al. Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Semin Pediatr Neurol 2007; 14: 73–79. doi: 10.1016/j.spen.2007.03.005. PMID: 17544950.
  49. Rekate H.L., Feiz-Erfan I., Ng Y.T. et al. Endoscopic surgery for hypothalamic hamartomas causing medically refractory gelastic epilepsy. Childs Nerv Syst 2006; 22: 874–880. doi: 10.1007/s00381-006-0125-4. PMID: 16770620.
  50. Bersnev V.P., Karashurov S.E., Darvish A.I. et al. [Electrical stimulation as a method of treatment of epilepsy]. Materials of the 4th international conference of neurosurgeons and neuropathologists. Khabarovsk; 2004: 354–361. (In Russ.)
  51. Romanelli P., Muacevic A., Striano S. Radiosurgery for hypothalamic hamartomas. Neurosurg Focus 2008; 24: E9. doi: 10.3171/FOC/2008/24/5/E9. PMID: 18447748.
  52. Mikhaylov V.A., Druzhinin A.K., Shova N.I., Korsakova E.A. [Epilepsy with geneticheskimi attacks and hamartoma of the hypothalamus (description of a rare clinical observation)]. Epilepsia i paroksizmal’nyye sostoyaniya 2017; 9(3): 64–72. doi: 10.17749/2077-8333.2017.9.3.064-072. (In Russ.)

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2020 Areshkina I.G., Dmitrenko D.V., Dmitrenko A.V., Narodova E.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies