Transendoscopic intraoperative recording of gelastic seizures from a hypothalamic hamartoma.

Journal Article

OBJECT: The differential diagnosis of hypothalamic masses in children includes hamartomas, which are associated with gelastic seizures and endocrine dysfunction. The purpose of this study was to utilize transendoscopic electroencephalography (EEG) recording at the time of tissue biopsy to further assist in diagnosis, determination of prognosis, and treatment planning. METHODS: We present the case of an infant with gelastic seizures and a large hypothalamic mass lesion. Despite a clinical and radiographic presentation typical of hypothalamic hamartoma (HH), slight growth on serial imaging raised concern for a diagnosis of intrinsic neoplasm. Biopsy of the lesion was recommended. RESULTS: Transventricular, endoscopic biopsy, was undertaken, with concurrent intraoperative, transendoscopic EEG recording using a standard epilepsy depth recording macroelectrode. Numerous electrographic seizures were recorded. Histopathology revealed a HH. CONCLUSION: This is the first report of intraoperative macroelectrode recording of electrographic seizures transendoscopically from a HH. This technique may prove useful for diagnosis, prognosis and treatment planning, as well as to guide transendoscopic therapeutic interventions for HH.

Full Text

Duke Authors

Cited Authors

  • Roberts, CM; Thompson, EM; Selden, NR

Published Date

  • January 2011

Published In

Volume / Issue

  • 47 / 2

Start / End Page

  • 147 - 151

PubMed ID

  • 21921578

Electronic International Standard Serial Number (EISSN)

  • 1423-0305

International Standard Serial Number (ISSN)

  • 1016-2291

Digital Object Identifier (DOI)

  • 10.1159/000330547

Language

  • eng