Deep brain stimulation for the treatment of drug-refractory epilepsy in a patient with a hypothalamic hamartoma: Case report

Carlo Efisio Marras, Michele Rizzi, Flavio Villani, Giuseppe Messina, France Sco Deleo, Roberto Cordella, Angelo Franzini

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Hypothalamic hamartomas (HHs) are developmental malformations associated with a range of neurological problems, including intractable seizures. There is increasing evidence of the epileptogenicity of the hamartoma and of the inhomogeneous distribution of the epileptic abnormalities within the malformation. The management strategy for treatment and results differ according to the insertion plane and the extension of the malformation into the hypothalamus. Cases characterized by extensive involvement of the hypothalamus are particularly challenging. The authors describe the case of a patient with drug-resistant epilepsy and a large hypothalamic hamartoma with an extensive area of attachment. The patient underwent implantation of 2 deep brain electrodes. The intraoperative recording showed a synchronous interictal epileptic discharge in the left temporal lobe and on the left side of the lesion. The patient was treated with chronic high-frequency stimulation. No side effects due to the stimulation were reported. At 18 months' follow-up, a reduction in complex partial seizure frequency was reported, but no significant reduction in overall seizure frequency was noticed (p = 0.14, t-test). The authors report on neurophysiological studies of the relationship between HH and epilepsy, and also discuss the literature on chronic high-frequency stimulation, including its rationale and the results of chronic stimulation of various targets for the treatment of drug-resistant epilepsy due to HH.

Original languageEnglish
Article numberE4
JournalNeurosurgical Focus
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2011

Fingerprint

Deep Brain Stimulation
Seizures
Hypothalamus
Hamartoma
Temporal Lobe
Therapeutics
Epilepsy
Electrodes
Drug Resistant Epilepsy
Hypothalamic hamartomas
Brain

Keywords

  • Deep brain stimulation
  • Gelastic seizure
  • Hypothalamic hamartoma
  • Invasive monitoring

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

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AU - Franzini, Angelo

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