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Gelastic Seizures Treated by Partial Resection of a Hypothalamic Hamartoma Takashi WATANABE 1 , Takao ENOMOTO 1 , Kazuya UEMURA 1 , Yuji TOMONO 1 , Tadao NOSE 1 1Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba Keyword: gelastic seizure , hypothalamic hamartoma , partial resection pp.923-928
Published Date 1998/10/10
DOI https://doi.org/10.11477/mf.1436901628
  • Abstract
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A 13-year-old girl developed atonic seizure at 2 years of age. At the age of 10 years, gelastic seizureswere noted. Magnetic resonance imaging (MRI) revealed a hypothalamic mass protruding down into thebasal cistern and up into the third ventricle. An interictal electroencephalogram (EEG) showed paroxysmalspike and wave complex discharges. Since the seizures failed to respond to medical therapy, it was decidedto try to control them by removing the mass. The operation was carried out through an interhemispherictrans-lamina terminalis approach. The lesion was so similar to normal brain tissue that the resectionhad tohe limited enough to avoid complications. Histological examination of the mass showed ahamartoma.

Postoperative MRI showed residual mass, but no seizure has been noted since the operation. The EEGre-corded one year after the operation showed no spike and wave complex discharge, although she was stillon anticonvulsant drugs. The authors propose that surgical therapy should be considered as a treatmentforintractable gelastic epilepsy with hypothalamic hamartoma and that the first operation should heconserva-tive enough to avoid complications, because it can bring about good results even if it is only a partial re-section.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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