Interstitial radiosurgery for the treatment of hypothalamic hamartomas

ABSTRACT

Patients presenting with hypothalamic hamartomas often are not only compromised by pharmacoresistant epileptic seizures, typically [gelastic epilepsy,] but also by behavioural problems and cognitive dysfunction. We report here on the effect of treatment using stereotactic interstitial radiosurgery with placement of [125] l-seeds into hypothalamic hamartomas in a pilot series of 9 patients. Outcome in terms of seizure reduction was complete seizure freedom or simple partial seizures only in 4 patients, significant reduction in seizure frequency in another 3 patients. Two patients did not profit from seed implantation. In patients rendered seizure free or suffering only from auras, improvement of behaviour was reported by parents and colleagues or schoolteachers. Parents' rating according to the Child Behaviour Checklist showed improvements with regard to social problems and attention. Self-rating of quality of life by adult patients showed improvements in activities, working situation, and self perception. There were no major side effects