Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery.
Neurosurgery
; 34(6): 949-58; discussion 958, 1994 Jun.
Article
en En
| MEDLINE
| ID: mdl-8084405
This study presents six patients with hypothalamic hamartomas diagnosed on the basis of magnetic resonance imaging. Histological confirmation was performed in three patients who underwent surgery. Immunohistological assays were used to determine the neurosecretory pattern. Four patients presented with epilepsy, including gelastic seizures. Other symptoms included behavioral abnormalities in four patients and precocious puberty and visual impairment in two patients. One patient presented associated developmental defects. Good results without morbidity were achieved with surgical resectioning in two patients with large hamartomas associated with behavioral abnormalities and gelastic epilepsy that was unresponsive to conventional medical treatment and in one patient with visual impairment. We propose a classification of the hypothalamic hamartomas based on topographical and clinical data obtained from 36 selected cases in the literature and six of our own cases. This classification should help to classify the various treatment methods and the surgical risks into four subgroups (Types la, lb, lla, and llb). We conclude that the surgical approach is a realistic alternative in certain cases, including large and broad-based Type llb hamartomas associated with gelastic epilepsy and behavioral disorders.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Epilepsia Generalizada
/
Epilepsia del Lóbulo Temporal
/
Hamartoma
/
Neoplasias Hipotalámicas
/
Risa
Tipo de estudio:
Diagnostic_studies
Límite:
Adult
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Neurosurgery
Año:
1994
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Estados Unidos