Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma - Case report
Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma - Case report
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DOI：
10.3171/jns.1998.89.4.0645
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发表时间：
1998-10-01
影响因子：
4.1
通讯作者：
Shinagawa, S
中科院分区：
文献类型：
--
作者：
Arita, K;Kurisu, K;Shinagawa, S
作者报告了一名因难以触及的下丘脑错构瘤而表现出顽固性癫痫的患者，随后接受了立体定向放射外科手术。这名 25 岁男性有 24 年顽固性痉挛性癫痫发作和强直阵挛性癫痫发作史。检查时以及 30 个月前进行的磁共振 (MR) 成像显示，患者右侧第三脑室底部有一个不增强、不进展的球形肿块，直径约 10 毫米。使用伽马刀进行局部放射治疗，对病灶中心照射 36 Gy，向病灶周围照射 18 Gy。这种治疗改善了癫痫发作的控制。在患者接受放射外科手术之前，尽管他认真遵守抗惊厥药物治疗方案，但每月仍会出现三到六次全身性癫痫发作。错瘤照射后，癫痫发作频率短暂增加，然后在治疗后 3 个月消退。患者在过去 21 个月内没有出现癫痫发作，也没有神经或内分泌并发症。治疗后 12 个月进行的磁共振成像显示病变完全消失。
The authors report on a patient who exhibited intractable epilepsy due to an inaccessible hypothalamic hamartoma and subsequently underwent stereotactic radiosurgery. This 25-year-old man had a 24-year history of intractable gelastic and tonic-clonic seizures. Magnetic resonance (MR) imaging performed at examination as well as that performed 30 months earlier demonstrated a nonenhancing and nonprogressive spherical mass, approximately 10 mm in diameter, located on the patient's right side at the floor of the third ventricle. Focal radiation treatment performed with a gamma knife unit administered 36 Gy to the center and 18 Gy to the periphery of the lesion. This treatment resulted in an improvement in seizure control. Before the patient underwent radiosurgery, he suffered from three to six greneralized seizures per month in spite of attentive compliance with an anticonvulsant medication regimen. After irradiation of the harmatoma, the frequency of the seizures transiently increased and then subsided 3 months posttreatment. The patient has been free of seizures for the last 21 months, with no neurological or endocrinological complications. Magnetic resonance imaging performed 12 months posttreatment demonstrated complete disappearance of the lesion.