下丘脑错构瘤引起的痴笑发作采用立体定向射频热凝术治疗。
Hypothalamic hamartoma causing gelastic seizures treated with stereotactic radiofrequency thermocoagulation.
机构信息
Neurosurgery Institute of Guangdong, Southern Medical University, Beijing, China.
出版信息
Epileptic Disord. 2009 Dec;11(4):333-8. doi: 10.1684/epd.2009.0275. Epub 2009 Dec 9.
PURPOSE
To present a case of small hypothalamic hamartoma (HH) causing gelastic seizures and treated with stereotactic radiofrequency thermocoagulation.
CASE REPORT
A 22-year-old man presented with intractable gelastic seizures and focal seizures refractory to medical treatment. Magnetic resonance imaging showed a 6 mm x 6 mm x 7 mm sessile intraventricular HH. Under local anesthesia, four intra-hamartoma lesions were made via stereotactic radiofrequency thermocoagulation using a depth electrode for recording and stimulation.
RESULTS
Transient central hyperthermia, hypertension, and tachycardia were observed during the coagulation procedure. Intra-hamartoma spikes and slow waves were identified on depth electrode recordings. No gelastic seizure was induced by deep stimulation. The patient was seizure-free during the 12-month follow up and no permanent surgical complications occurred.
CONCLUSION
Stereotactic radiofrequency thermocoagulation may be an effective and safe treatment option in selected cases of hypothalamic hamartoma with gelastic seizures.
目的
报告 1 例下丘脑错构瘤（HH）引起痴笑发作，经立体定向射频热凝治疗。
病例报告
1 名 22 岁男性，表现为难治性痴笑发作和局灶性癫痫，药物治疗无效。磁共振成像显示 6mm×6mm×7mm 无蒂室管膜下 HH。在局部麻醉下，使用深部电极进行记录和刺激，通过立体定向射频热凝术在四个 HH 内病灶中进行了治疗。
结果
在凝固过程中观察到短暂的中枢性高热、高血压和心动过速。在深部电极记录中发现 HH 内棘波和慢波。深部刺激未引起痴笑发作。患者在 12 个月的随访期间无癫痫发作，且无永久性手术并发症。
结论
在某些下丘脑 HH 引起痴笑发作的病例中，立体定向射频热凝术可能是一种有效且安全的治疗选择。
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