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Titolo:
Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy
Autore:
Rosenfeld, JV; Harvey, AS; Wrennall, J; Zacharin, M; Berkovic, SF;
Indirizzi:
Royal Childrens Hosp, Dept Neurosurg, Parkville, Vic 3052, Australia RoyalChildrens Hosp Parkville Vic Australia 3052 le, Vic 3052, Australia Royal Childrens Hosp, Childrens Epilepsy Program, Parkville, Vic 3052, Australia Royal Childrens Hosp Parkville Vic Australia 3052 le, Vic 3052, Australia Royal Childrens Hosp, Dept Neurol, Parkville, Vic 3052, Australia Royal Childrens Hosp Parkville Vic Australia 3052 le, Vic 3052, Australia Royal Childrens Hosp, Dept Psychol, Parkville, Vic 3052, Australia Royal Childrens Hosp Parkville Vic Australia 3052 le, Vic 3052, Australia Royal Childrens Hosp, Dept Endocrinol, Parkville, Vic 3052, Australia Royal Childrens Hosp Parkville Vic Australia 3052 le, Vic 3052, Australia Univ Melbourne, Dept Surg, Melbourne, Vic, Australia Univ Melbourne Melbourne Vic Australia t Surg, Melbourne, Vic, Australia Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia Univ Melbourne Melbourne Vic Australia aediat, Melbourne, Vic, Australia Univ Melbourne, Dept Med, Melbourne, Vic, Australia Univ Melbourne Melbourne Vic Australia pt Med, Melbourne, Vic, Australia Austin & Repatriat Med Ctr, Epilepsy Res Inst, Melbourne, Vic, Australia Austin & Repatriat Med Ctr Melbourne Vic Australia ourne, Vic, Australia
Titolo Testata:
NEUROSURGERY
fascicolo: 1, volume: 48, anno: 2001,
pagine: 108 - 118
SICI:
0148-396X(200101)48:1<108:TROHHW>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRECOCIOUS PUBERTY; SURGICAL-TREATMENT; ICTAL LAUGHTER; EEG;
Keywords:
epilepsy surgery; gelastic seizures; hypothalamic hamartoma; precocious puberty;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Rosenfeld, JV Royal Childrens Hosp, Dept Neurosurg, Flemington Rd, Parkville, Vic 3052, Australia Royal Childrens Hosp Flemington Rd Parkville Vic Australia 3052
Citazione:
J.V. Rosenfeld et al., "Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy", NEUROSURGER, 48(1), 2001, pp. 108-118

Abstract

OBJECTIVE: Hypothalamic hamartomas (HHs) are associated with precocious puberty and gelastic epilepsy; the seizures are often refractory to antiepileptic medications and associated with delayed development and disturbed behavior. The current opinion is that surgery to treat intrahypothalamic lesions is formidable and that complete excision is not technically achievable. We report our experience with a transcallosal approach to the resection of HHs. METHODS: Five children (age, 4-13 yr) with intractable epilepsy and HHs underwent preoperative clinical, electroencephalographic, and imaging evaluations. Two patients experienced only gelastic seizures, and three patients experienced mixed seizure disorders with drop attacks; all experienced multiple daily seizures. Patients were evaluated with respect to seizures, cognition, behavior, and endocrine status 9 to 37 months (mean, 24 mo) after surgery, The HHs were approached via a transcallosal-interforniceal route to the third ventricle and were resected using a microsurgical technique and frameless stereotaxy,RESULTS: Complete or nearly complete (>95%) excision of the HHs was achieved for all patients, with no adverse neurological, psychological, or visualsequelae. Two patients experienced mild transient diabetes insipidus aftersurgery. Two patients developed appetite stimulation, but no other significant. endocrinological sequelae were observed. Three patients are seizure-free and two patients have experienced only occasional, brief, mild gelasticseizures after surgery, all with reduced antiepileptic medications. On thebasis of parental reports and our own subjective observations, the children also exhibited marked improvements in behavior, school performance, and quality of life. CONCLUSION: Complete or nearly complete resection of HHs can be safely achieved via a transcallosal approach, with the possibility of seizure freedomand neurobehavioral Improvements.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 15:55:16