Gamma Knife Radiosurgery for Refractory Epilepsy Caused by Hypothalamic Hamartomas

2006 ◽  
Vol 84 (2-3) ◽  
pp. 82-87 ◽  
Author(s):  
David Mathieu ◽  
Douglas Kondziolka ◽  
Ajay Niranjan ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Gamma Knife ◽  
Refractory Epilepsy ◽  
Gamma Knife Radiosurgery ◽  
Hypothalamic Hamartomas

Gamma Knife Radiosurgery for Hypothalamic Hamartomas: Systematic Review

2021 ◽  
Author(s):  
Aditya M. Kondajji ◽  
Audree Evans ◽  
Ansley Unterberger ◽  
Daniel Kulinich ◽  
Kevin Ding ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Hypothalamic Hamartomas

Hypothalamic Hamartomas: Neuropathological Features with and without Prior Gamma Knife Radiosurgery

2013 ◽  
Vol 91 (1) ◽  
pp. 45-55 ◽  
Author(s):  
John F. Kerrigan ◽  
Angela Parsons ◽  
Stephen G. Rice ◽  
Kristina Simeone ◽  
Andrew G. Shetter ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Hypothalamic Hamartomas

Gamma Knife surgery for hypothalamic hamartomas causing refractory epilepsy: preliminary results from a prospective observational study

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 215-221 ◽  
Author(s):  
David Mathieu ◽  
Charles Deacon ◽  
Catherine-Andrée Pinard ◽  
Brendan Kenny ◽  
Julie Duval
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Antiepileptic Drugs ◽  
Gamma Knife ◽  
Prospective Observational Study ◽  
Refractory Epilepsy ◽  
Gamma Knife Surgery ◽  
Hypothalamic Hamartomas ◽  
Treatment Volume

Object Hypothalamic hamartomas (HHs) are congenital lesions typically presenting with medically refractory epilepsy. Open or endoscopic surgical procedures to remove or disconnect the hamartoma have been reported to be effective but are associated with significant morbidity. The authors of studies on Gamma Knife surgery for HHs have reported an encouraging rate of epilepsy resolution with minimal side effects. At the Centre Hospitalier Universitaire de Sherbrooke, the authors have undertaken a prospective observational study of the outcomes of patients who underwent radiosurgery for HHs. Methods Patients were included in the study if they had an HH, refractory epilepsy, and no other suspected seizure focus. After radiosurgery, seizure status was assessed every 3 months and reported using the Engel Classification. Quality of life evaluation was performed annually using a standardized questionnaire, and neuropsychological evaluation was performed after 2 years. Results Nine patients were included in the study. They ranged in age from 12 to 57 years. Epilepsy began in infancy in all cases and was refractory to standard antiepileptic drugs. The patients received an average of 2 antiepileptic drugs before undergoing radiosurgery. Using the Régis Classification, 6 patients had smaller hamartomas (Grade I–III) and underwent treatment of the entire lesion, using a margin dose of 14–20 Gy. Treatment volume ranged from 0.3 to 1.0 ml. Three patients had larger lesions (Grade IV–VI) for which a radiosurgical disconnection was attempted, targeting the area of attachment to the hypothalamus. For those patients, the margin dose was 15 or 16 Gy, with treatment volume ranging from 0.8 to 1.8 ml. In all patients, the radiation dose received by the optic pathways was kept below 10 Gy. Disconnection led to no improvement in epilepsy (Engel Class IV). Four patients in whom the entire lesion was treated are now seizure free (Engel Class I), with another having only rare seizures (Engel Class II). Quality of life and verbal memory were improved in those patients with more than 3 years of follow-up. No adverse event occurred after radiosurgery. Conclusions Radiosurgery safely and effectively controlled the epileptic disorder in patients with HHs when the entire lesion could be targeted. Radiosurgical disconnection is ineffective and cannot be recommended.

Gamma knife radiosurgery for hypothalamic hamartomas in patients with medically intractable epilepsy and precocious puberty

2000 ◽  
Vol 92 (4) ◽  
pp. 726-731 ◽  
Author(s):  
Frank Unger ◽  
Oskar Schröttner ◽  
Klaus Haselsberger ◽  
Eva Körner ◽  
Robert Ploier ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Gamma Knife ◽  
Precocious Puberty ◽  
Seizure Control ◽  
Gamma Knife Radiosurgery ◽  
Content Type ◽  
Hypothalamic Hamartomas ◽  
Gelastic Epilepsy ◽  
Fine Print

✓ Hamartoma of the hypothalamus represents a well-known but rare cause of central precocious puberty and gelastic epilepsy. Due to the delicate site in which the tumor is located, surgery is often unsuccessful and associated with considerable risks. In the two cases presented, gamma knife radiosurgery was applied as a safe and noninvasive alternative to obtain seizure control.Two patients, a 13-year-old boy and a 6-year-old girl, presented with medically intractable gelastic epilepsy and increasing episodes of secondary generalized seizures. Abnormal behavior and precocious puberty were also evident. Magnetic resonance (MR) imaging revealed hypothalamic hamartomas measuring 13 and 11 mm, respectively. After general anesthesia had been induced in the patients, radiosurgical treatment was performed with margin doses of 12 Gy to 90% and 60% of isodose areas, covering volumes of 700 and 500 mm3, respectively.After follow-up periods of 54 months in the boy and 36 months in the girl, progressive decrease in both seizure frequency and intensity was noted (Engel outcome scores IIa and IIIa, respectively). Both patients are currently able to attend public school. Follow-up MR imaging has not revealed significant changes in the sizes of the lesions.Gamma knife radiosurgery can be an effective and safe treatment modality for achieving good seizure control in patients with hypothalamic hamartomas.

4. Gamma knife surgery for hypothalamic hamartomas causing refractory epilepsy: Long-term outcomes – A prospective observational study

2016 ◽  
Vol 127 (9) ◽  
pp. e166
Author(s):  
Véronique Martel ◽  
David Mathieu ◽  
Catherine-Andrée Pinard ◽  
Pascale Bourgeois ◽  
Julie Duval ◽  
...  
Keyword(s):  
Observational Study ◽  
Gamma Knife ◽  
Prospective Observational Study ◽  
Refractory Epilepsy ◽  
Gamma Knife Surgery ◽  
Long Term Outcomes ◽  
Hypothalamic Hamartomas

The Effect of Gamma Knife Radiosurgery on the Molecular Biology of Meningiomas

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
V. Bulthuis ◽  
W. De Jong ◽  
Y. Yakkioui ◽  
P. Hanssens ◽  
Y. Temel ◽  
...  
Keyword(s):  
Molecular Biology ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery
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