Wright James M, Staudt Michael D, Alonso Andrea, Miller Jonathan P, Sloan Andrew E
1Department of Neurological Surgery, University Hospitals, Case Western Reserve University.
3Case Western Reserve University School of Medicine, Cleveland, Ohio; and.
J Neurosurg Pediatr. 2018 Mar;21(3):302-307. doi: 10.3171/2017.9.PEDS1747. Epub 2018 Jan 12.
The authors describe the case of a 22-month-old boy who presented with gelastic seizures and developmental delay. Magnetic resonance imaging and video-electroencephalography monitoring revealed a primarily intraventricular hypothalamic hamartoma and gelastic seizures occurring 20-30 times daily. The patient was treated with various regimens of antiepileptic medications for 16 months, but the seizures remained medically intractable. At 3 years of age, he underwent stereotactic laser ablation with an aim of disconnection of the lesion. The procedure was performed with the NeuroBlate SideFire probe. To the authors' knowledge, this is the first reported use of this technology for this procedure and serves as proof of concept. There were no perioperative complications, and 2 years postprocedure, the patient remains seizure free with marked behavioral and cognitive improvements.
作者描述了一名22个月大男孩的病例，该男孩出现痴笑发作和发育迟缓。磁共振成像和视频脑电图监测显示主要为脑室内下丘脑错构瘤，且每天出现20 - 30次痴笑发作。该患者接受了多种抗癫痫药物治疗方案，为期16个月，但癫痫发作在药物治疗上仍难以控制。3岁时，他接受了立体定向激光消融术，目的是切断病变。手术使用了NeuroBlate SideFire探头。据作者所知，这是首次报道将该技术用于此手术，且可作为概念验证。围手术期无并发症，术后2年，患者无癫痫发作，行为和认知有显著改善。
