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Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment.
- Source :
-
Neurology [Neurology] 1993 Apr; Vol. 43 (4), pp. 747-50. - Publication Year :
- 1993
-
Abstract
- We retrospectively studied 12 consecutive patients with gelastic seizures and hypothalamic hamartomas who, because of intractable epilepsy, underwent chronic intracranial EEG monitoring or epilepsy surgery. All patients had medically refractory seizures that included laughter as an ictal behavior (gelastic seizures). The hypothalamic hamartomas were identified with neuroimaging studies (12 of 12) and by pathologic verification (four of 12). Associated clinical features included behavioral disorders (n = 5), developmental delay (n = 4), and precocious puberty (n = 2). Interictal extracranial EEG predominantly showed bi-hemispheric epileptiform changes suggesting a secondary generalized epileptic disorder. Intracranial EEG recordings, performed in eight patients, indicated the apparent focal onset of seizure activity (anterior temporal lobe [n = 7] and frontal lobe [n = 1]). None of the seven patients who underwent a focal cortical resection, however, experienced a significant reduction in seizure tendency. An anterior corpus callosotomy, performed in two patients with symptomatic generalized epilepsy, resulted in a worthwhile reduction in drop attacks. Results of this study may modify the surgical strategies in patients with gelastic seizures and hypothalamic hamartomas.
- Subjects :
- Child
Child, Preschool
Electroencephalography
Female
Frontal Lobe pathology
Frontal Lobe surgery
Hamartoma complications
Hamartoma surgery
Hippocampus pathology
Hippocampus surgery
Humans
Hypothalamic Neoplasms complications
Hypothalamic Neoplasms surgery
Infant
Intellectual Disability complications
Laughter
Magnetic Resonance Imaging
Male
Puberty, Precocious complications
Retrospective Studies
Temporal Lobe pathology
Temporal Lobe surgery
Treatment Outcome
Epilepsies, Partial etiology
Hamartoma diagnosis
Hypothalamic Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0028-3878
- Volume :
- 43
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 8469334
- Full Text :
- https://doi.org/10.1212/wnl.43.4.747