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Melikyan A.G.

Burdenko Neurosurgical Center

Surgical treatment of epilepsy in patients with hypothalamic hamartomas

Authors:

Melikyan A.G.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2022;86(4): 83‑88

DOI: 10.17116/neiro202286041

Read: 2843 times

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Table of contents

SURGICAL TREATMENT OF EPILEPSY IN PATIENTS WITH HYPOTHALAMIC HAMARTOMAS
SURGICAL TREATMENT OF EPILEPSY IN PATIENTS WITH HYPOTHALAMIC HAMARTOMAS

To cite this article:

Melikyan AG. Surgical treatment of epilepsy in patients with hypothalamic hamartomas. Burdenko's Journal of Neurosurgery. 2022;86(4):83‑88. (In Russ., In Engl.)
https://doi.org/10.17116/neiro202286041

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
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Abstract:

The purpose of this review was to analyze the current ideas about various techniques and methods for treating epilepsy in patients with hypothalamic hamartomas including microsurgery, endoscopy, radiofrequency thermal destruction, stereotactic laser ablation and radiosurgery. Data characterizing their effectiveness, limitations and complications are considered.

CONCLUSION

When choosing the optimal treatment option, it is necessary to take into account patient age and course of disease, anatomical and topographic features of hamartoma location, previous attempts of treatment, opinion of the patient and his guardians, as well as surgical experience.

Keywords:

hypothalamic hamartoma
epilepsy
endoscopy
radiofrequency thermal destruction
stereotactic laser ablation
radiosurgery for hamartoma

Authors:

Melikyan A.G.

Burdenko Neurosurgical Center

Received:

11.03.2022

Accepted:

10.06.2022

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References:

  1. Mittal S, Mittal M, Montes JL, Farmer JP, Andermann F. Hypothalamic hamartomas. Part 1. Clinical, neuroimaging, and neurophysiological characteristics. Neurosurgical Focus. 2013;34(6):1-12.  https://doi.org/10.3171/2013.3.focus1355
  2. Boyko OB, Curnes JT, Oakes WJ, Burger PC. Hamartomas of the tuber cinereum: CT, MR, and pathologic findings. AJNR. American Journal of Neuroradiology. 1991;12(2):309-314. 
  3. Arita K, Ikawa F, Kurisu K, Sumida M, Harada K, Uozumi T, Monden S., Nishi Y. The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. Journal of Neurosurgery. 1999;91(2):212-220.  https://doi.org/10.3171/jns.1999.91.2.0212
  4. Chan YM, Fenoglio-Simeone KA, Paraschos S, Muhammad L, Troester MM, Ng YT, Johnsonbaugh RE, Coons SW, Prenger EC, Kerrigan JF Jr, Seminara SB. Central precocious puberty due to hypothalamic hamartomas correlates with anatomic features but not with expression of GnRH, TGFα, or KISS1. Hormone Research in Paediatrics. 2010;73(5):312-319.  https://doi.org/10.1159/000308162
  5. Brandberg G, Raininko R, Eeg-Olofsson O. Hypothalamic hamartoma with gelastic seizures in Swedish children and adolescents. European Journal of Paediatric Neurology: EJPN. 2004;8(1):35-44.  https://doi.org/10.1016/j.ejpn.2003.10.003
  6. Arzimanoglou AA, Hirsch E, Aicardi J. Hypothalamic hamartoma and epilepsy in children: Illustrative cases of possible evolutions. Epileptic Disorders. 2003;5(4):187-199. 
  7. Berkovic SF, Kuzniecky RI, Andermann F. Human epileptogenesis and hypothalamic hamartomas: new lessons from an experiment of nature. Epilepsia. 1997;38(1):1-3.  https://doi.org/10.1111/j.1528-1157.1997.tb01072.x
  8. Palmini A, Paglioli-Neto E, Montes J, Farmer JP. The treatment of patients with hypothalamic hamartomas, epilepsy and behavioural abnormalities: Facts and hypotheses. Epileptic Disorders. 2003;5(4):249-255. 
  9. Munari C, Kahane P, Francione S, Hoffmann D, Tassi L, Cusmai R, Vigevano F, Pascuier B, BettiO-O. Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalography and Clinical Neurophysiology. 1995;95(3):154-160.  https://doi.org/10.1016/0013-4694(95)00063-5
  10. 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 Disorders. 2003;5(4):205-217. 
  11. Wu J, Gao M, Shen JX, Qiu SF, Kerrigan JF. Mechanisms of intrinsic epileptogenesis in human gelastic seizures with hypothalamic hamartoma. CNS Neuroscience and Therapeutics. 2015;21(2):104-111.  https://doi.org/10.1111/cns.12348
  12. Berkovic SF, Arzimanoglou A, Kuzniecky R, Harvey AS, Palmini A, Andermann F. Hypothalamic hamartoma and seizures: A treatable epileptic encephalopathy. Epilepsia. 2003;44(7):969-973.  https://doi.org/10.1046/j.1528-1157.2003.59102.x
  13. Freeman JL, Harvey AS, Rosenfeld J V, Wrennall JA, Bailey CA, Berkovic SF. Generalized epilepsy in hypothalamic hamartoma: Evolution and postoperative resolution. Neurology. 2003;60(5):762-767.  https://doi.org/10.1212/01.wnl.0000049457.05670.7d
  14. Rosenfeld JV, Harvey AS, Wrennall J, Zacharin M, Berkovic SF. Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy. Neurosurgery. 2001;48(1):108-118.  https://doi.org/10.1097/00006123-200101000-00019
  15. Berg AT, Langfitt JT, Cascino GD. The changing landscape of epilepsy surgery. Neurology. 2018;91(2):1-3.  https://doi.org/10.1212/wnl.0000000000005764
  16. Cascino GD, Andermann F, Berkovic SF, Kuzniecky RI, Sharbrough FW, Keene DL, Bldin P, Kelly P, Olivier A, Fendel W. Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology. 1993;43(4):747-750.  https://doi.org/10.1212/wnl.43.4.747
  17. Valdueza JM, Cristante L, Dammann O, Bentele K, Vortmeyer A, Saeger W, Radberg B, Freitag J, Hermann H. Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery. 1994;34(6):949-958; discussion 958.  https://doi.org/10.1227/00006123-199406000-00001
  18. Régis J, Scavarda D, Tamura M, Nagayi M, Villeneuve N, Bartolomei F, Brue T, Dafonseca D, Chauvel P. Epilepsy related to hypothalamic hamartomas: surgical management with special reference to gamma knife surgery. Child’s Nervous System: ChNS. 2006;22(8):881-895.  https://doi.org/10.1007/s00381-006-0139-y
  19. Choi JU, Yang KH, Kim TG, Chang JH, Chang JW, Lee BI, Kim DS. Endoscopic disconnection for hypothalamic hamartoma with intractable seizure: Report of four cases. Journal of Neurosurgery. 2004;100(5 Suppl.):506-511.  https://doi.org/10.3171/ped.2004.100.5.0506
  20. Delalande O, Fohlen M. Disconnecting surgical treatment of hypothalamic hamartoma in children and adults with refractory epilepsy and proposal of a new classification. Neurologia Medico-Chirurgica. 2003;43(2):61-68.  https://doi.org/10.2176/nmc.43.61
  21. Northfield DWC, Russell DS. Pubertas praecox due to hypothalamic hamartoma: report of two cases surviving surgical removal of the tumour. Journal of Neurology, Neurosurgery, and Psychiatry. 1967;30(2):166-173.  https://doi.org/10.1136/jnnp.30.2.166
  22. Machado HR, Hoffman HJ, Hwang PA. Gelastic seizures treated by resection of a hypothalamic hamartoma. Child’s Nervous System: ChNS. 1991;7(8):462-465.  https://doi.org/10.1007/BF00263190
  23. Nishio S, Morioka T, Fukui M, Goto Y. Surgical Treatment of Intractable Seizures Due to Hypothalamic Hamartoma. Epilepsia. 1994;35(3):514-519.  https://doi.org/10.1111/j.1528-1157.1994.tb02470.x
  24. Mottolese C, Stan H, Bret P, Berlier P, Lapras C. Hypothalamic hamartoma: the role of surgery in a series of eight patients. Child’s Nervous System: ChNS. 2001;17(4):229-238.  https://doi.org/10.1007/s003810000361
  25. Watanabe T, Enomoto T, Uemura K, Tomono Y, Nose T. [Gelastic seizures treated by partial resection of a hypothalamic hamartoma]. No Shinkei Geka. Neurological Surgery. 1998;26(10):923-928. 
  26. Abla AA, Rekate HL, Wilson DA, Wait SD, Uschold TD, Prenger E, Ng Y-T, Nakaji P, Kerrigaan J. Orbitozygomatic resection for hypothalamic hamartoma and epilepsy: patient selection and outcome. Child’s Nervous System: ChNS. 2011;27(2):265-277.  https://doi.org/10.1007/s00381-010-1250-7
  27. Miller ML, Kaufman BA, Lew SM. Modified osteoplastic orbitozygomatic craniotomy in the pediatric population. Child’s Nervous System: ChNS. 2008;24(7):845-850.  https://doi.org/10.1007/s00381-007-0575-3
  28. Grigoryev AYu, Trifonov IS, Sinkin MV, Grigorieva EV, Kaimovskiy EV, Shishkina LV, Krylov VV. Transnasal endoscopic removal of hypothalamic hamartoma (case reports). Nejrohirurgiya. 2019;21(1):72-82.  https://10.17650/1683-3295-2019-21-1-72-82
  29. Rosenfeld JV. The evolution of treatment for hypothalamic hamartoma: A personal odyssey. Neurosurgical Focus. 2011;30(2):1-5.  https://doi.org/10.3171/2010.11.focus10244
  30. Bourdillon P, Ferrand-Sorbet S, Apra C, Chipaux M, Raffo E, Rosenberg S, Bulteau C, Dorison N, Bekaert O, Dinkelacker V, Le Guerinel C, Fohlen M, Dorfmuller G. Surgical treatment of hypothalamic hamartomas. Neurosurgical Review. 2021;44(2):753-762.  https://doi.org/10.1007/s10143-020-01298-z
  31. Ng YT, Rekate HL, Prenger EC, Chung SS, Feiz-Erfan I, Wang NC, Varlan M, Kerrigan J. Transcallosal resection of hypothalamic hamartoma for intractable epilepsy. Epilepsia. 2006;47(7):1192-202.  https://doi.org/10.1111/j.1528-1167.2006.00516.x
  32. Harvey AS, Freeman JL, Berkovic SF, Rosenfeld J V. Transcallosal resection of hypothalamic hamartomas in patients with intractable epilepsy. Epileptic Disorders. 2003;5(4):257-265. 
  33. van Tonder L, Burn S, Iyer A, Blair J, Didi M, Carter M, Martland T, Malucci C, Chawira A. Open resection of hypothalamic hamartomas for intractable epilepsy revisited, using intraoperative MRI. Child’s Nervous System: ChNS. 2018;34(9):1663-1673. https://doi.org/10.1007/s00381-018-3786-x
  34. Calisto A, Dorfmüller G, Fohlen M, Bulteau C, Conti A, Delalande O. Endoscopic disconnection of hypothalamic hamartomas: Safety and feasibility of robot-assisted, thulium laser-based procedures. Journal of Neurosurgery. Pediatrics. 2014;14(6):563-572.  https://doi.org/10.3171/2014.8.peds13586
  35. Procaccini E, Dorfmüller G, Fohlen M, Bulteau C, Delalande O. Surgical management of hypothalamic hamartomas with epilepsy: The stereoendoscopic approach. Neurosurgery. 2006;59(4 Suppl 2):ONS336-ONS346. https://doi.org/10.1227/01.neu.0000233900.06146.72
  36. Rekate HL, Feiz-Erfan I, Ng YT, Gonzalez LF, Kerrigan JF. Endoscopic surgery for hypothalamic hamartomas causing medically refractory gelastic epilepsy. Child’s Nervous System: ChNS. 2006;22(8):874-880.  https://doi.org/10.1007/s00381-006-0125-4
  37. Shim K-W, Chang J-H, Park Y-G, Kim H-D, Choi J-U, Kim D-S. Treatment modality for intractable epilepsy in hypothalamic hamartomatous lesions. Neurosurgery. 2008;62(4):847-856; discussion 856.  https://doi.org/10.1227/01.neu.0000318170.82719.7c
  38. Dorfmuller G. Endoscopic Disconnection of Hypothalamic Hamartomas in Children [Internet]. ESTM Webinar Series: Global Epilepsy Surgery Technique Rounds. Nov 15, 2020. Accessed June 01, 2022. https://www.youtube.com/watch?v=gyOMVlVULig&t=240s
  39. Fukuda M, Kameyama S, Wachi M, Tanaka R. Stereotaxy for hypothalamic hamartoma with intractable gelastic seizures: technical case report. Neurosurgery. 1999;44(6):1347-1350. https://doi.org/10.1097/00006123-199906000-00115
  40. Kuzniecky R, Guthrie B, Mountz J, Bebin M, Faught E, Gilliam F, Liu H. Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Annals of Neurology. 1997;42(1):60-67.  https://doi.org/10.1002/ana.410420111
  41. Addas B, Sherman EMS, Hader WJ. Surgical management of hypothalamic hamartomas in patients with gelastic epilepsy. Neurosurgical Focus. 2008;25(3):8.  https://doi.org/10.3171/foc/2008/25/9/e8
  42. Homma J, Kameyama S, Masuda H, Ueno T, Fujimoto A, Oishi M, Fukuda M. Stereotactic radiofrequency thermocoagulation for hypothalamic hamartoma with intractable gelastic seizures. Epilepsy Research. 2007;76(1):15-21.  https://doi.org/10.1016/j.eplepsyres.2007.06.007
  43. Shirozu H, Masuda H, Ito Y, Sonoda M, Kameyama S. Stereotactic radiofrequency thermocoagulation for giant hypothalamic hamartoma. Journal of Neurosurgery. 2016;125(4):812-821.  https://doi.org/10.3171/2015.6.jns15200
  44. Kameyama S, Shirozu H, Masuda H, Ito Y, Sonoda M, Akazawa K. MRI-guided stereotactic radiofrequency thermocoagulation for 100 hypothalamic hamartomas. Journal of Neurosurgery. 2016;124(5):1503-1512. https://doi.org/10.3171/2015.4.jns1582
  45. Wilfong AA, Curry DJ. Hypothalamic hamartomas: Optimal approach to clinical evaluation and diagnosis. Epilepsia. 2013;54(Suppl. 9):109-114.  https://doi.org/10.1111/epi.12454
  46. Zubkov S, Del Bene VA, MacAllister WS, Shepherd TM, Devinsky O. Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy. Epilepsy and Behavior Case Reports. 2015;4:60-62.  https://doi.org/10.1016/j.ebcr.2015.07.002
  47. Rolston JD, Chang EF. Stereotactic Laser Ablation for Hypothalamic Hamartoma. Neurosurgery Clinics of North America. 2016;27(1):59-67.  https://doi.org/10.1016/j.nec.2015.08.007
  48. Du VX, Gandhi S V, Rekate HL, Mehta AD. Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma? Epilepsia. 2017;58 Suppl 2:77-84.  https://doi.org/10.1111/epi.13751
  49. Arocho-Quinones EV, Koop J, Lew SM. Improvement of Hypothalamic Hamartoma-Related Psychiatric Disorder after Stereotactic Laser Ablation: Case Report and Review of Literature. World Neurosurgery. 2019;122:680-683.  https://doi.org/10.1016/j.wneu.2018.11.166
  50. Curry DJ, Raskin J, Ali I, Wilfong AA. MR-guided laser ablation for the treatment of hypothalamic hamartomas. Epilepsy Research. 2018;142:131-134.  https://doi.org/10.1016/j.eplepsyres.2018.03.013
  51. Kerrigan JF, Parsons A, Tsang C, Simeone K, Coons S, Wu J. Hypothalamic hamartoma: Neuropathology and epileptogenesis. Epilepsia. 2017;58 Suppl 2:22-31.  https://doi.org/10.1111/epi.13752
  52. Boerwinkle VL, Foldes ST, Torrisi SJ, Temkit H, Gaillard WD, Kerrigan JF, Desai V, Raskin J, Vedantam A, Jarrar R, Williams K, Lam , Ranjan M, Broderson J, Adelson D, Wilfong A, Curry D. Subcentimeter epilepsy surgery targets by resting state functional magnetic resonance imaging can improve outcomes in hypothalamic hamartoma. Epilepsia. 2018;59(12):2284-2295. https://doi.org/10.1111/epi.14583
  53. Schulze-Bonhage A, Quiske A, Homberg V, Trippel M, Wagner K, Frings L, Bast T, Huppertz H-J, Warnke C, Ostertag Ch. Effect of interstitial stereotactic radiosurgery on behavior and subjective handicap of epilepsy in patients with gelastic epilepsy. Epilepsy and Behavior: E&B. 2004;5(1):94-101.  https://doi.org/10.1016/j.yebeh.2003.11.021
  54. Selch MT, Gorgulho A, Mattozo C, Solberg TD, Cabatan-Awang C, DeSalles AAF. Linear accelerator stereotactic radiosurgery for the treatment of gelastic seizures due to hypothalamic hamartoma. Minimally Invasive Neurosurgery: MIN. 2005;48(5):310-314.  https://doi.org/10.1055/s-2005-915598
  55. Golanov AV, Kornienko VN, Trunin YuYu, Kostiuchenko VV, Gorlachev GE, Gorelyshev SK, Melikian AG, Khukhleva EA, Mazerkina NA, Sorokin VA. Stereotactic radiosurgery in treatment of patients with hypothalamic hamartomas. Voprosy nejrohirurgii imeni N.N. Burdenko. 2010;1:24-29. (In Russ.).
  56. Dunoyer C, Ragheb J, Resnick T, Alvarez L, Jayakar P, Altman N, Wolf A, Duchowny M. The use of stereotactic radiosurgery to treat intractable childhood partial epilepsy. Epilepsia. 2002;43(3):292-300.  https://doi.org/10.1046/j.1528-1157.2002.06501.x
  57. Mathieu D, Kondziolka D, Niranjan A, Flickinger J, Lunsford LD. Gamma knife radiosurgery for refractory epilepsy caused by hypothalamic hamartomas. Stereotactic and Functional Neurosurgery. 2006;84(2-3):82-87.  https://doi.org/10.1159/000094036
  58. Unger F, Schröttner O, Feichtinger M, Bone G, Haselsberger K, Sutter B. Stereotactic radiosurgery for hypothalamic hamartomas. Acta Neurochirurgica. Supplement. 2002;84:57-63.  https://doi.org/10.1007/978-3-7091-6117-3_6
  59. Régis J, Lagmari M, Carron R, Hayashi M, McGonigal A, Daquin G, Volleneuve N, Laguitton V, Bartolomei F, Chauvel P. Safety and efficacy of Gamma Knife radiosurgery in hypothalamic hamartomas with severe epilepsies: A prospective trial in 48 patients and review of the literature. Epilepsia. 2017;58(Suppl 2):60-71.  https://doi.org/10.1111/epi.13754
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