Open radiofrequency ablation for the management of intractable epilepsy associated with sessile hypothalamic hamartoma
Open radiofrequency ablation for the management of intractable epilepsy associated with sessile hypothalamic hamartoma
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DOI：
10.1055/s-2004-830267
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发表时间：
2005-06-01
影响因子：
--
通讯作者：
Yoshimine, T
中科院分区：
文献类型：
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作者：
Fujimoto, Y;Kato, A;Yoshimine, T
无蒂性下丘脑错构瘤（HH）常引起难治性癫痫，即使显微手术切除和伽玛刀手术（GKS）也难以控制，特别是当错构瘤位于下丘脑内、较大或形状不规则时。我们成功地应用射频消融（RFA），以减少其致痫性和断开癫痫传播。患者是一名26岁的男性，从6个月大开始出现难治性癫痫和严重精神发育迟滞。他接受了三次手术，部分切除和传统的放射治疗。残留的HH很薄，形状像一个弯曲的板，广泛地附着在第三脑室的底部。他在严格的影像引导下，通过经胼胝体脉络膜下入路接受了开放性RFA，导致癫痫发作立即显著缓解，无并发症。这表明开放式RFA是一种微创技术，适用于难以通过其他方式治疗的不规则形状HH。
Sessile hypothalamic hamartoma (HH) often causes intractable epilepsy, which is difficult to control even by microsurgical resection and gamma knife surgery (GKS), especially when the hamartoma is intrahypothalamic, large, or irregularly shaped. We successfully applied radiofrequency ablation (RFA) to reduce its epileptogenicity and to disconnect seizure propagation. The patient was a 26-year-old man who presented with refractory epilepsy and severe mental retardation from age 6 months. He had undergone three surgeries yielding partial resection and conventional irradiation treatments. The residual HH was thin and shaped like a bent plate, attached widely to the floor of the third ventricle. He underwent open RFA via the transcallosal sub-choroidal approach under strict image guidance, which resulted in immediate and remarkable seizure remission without complications. This suggests that open RFA is a minimally invasive technique for an irregularly shaped HH that is difficult to treat by other modalities.