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Multicenter Study
. 2024 Aug;9(4):1493-1501.
doi: 10.1002/epi4.12989. Epub 2024 Jun 26.

Surgical and radiosurgical treatment of hypothalamic hamartoma: The Italian experience between 2011 and 2021

Michele Rizzi  1 , Alessandro Consales  2 , Irene Tramacere  3 , Alessandro De Benedictis  4 , Antonella Bua  4 , Nicola Specchio  5 , Luca De Palma  5 , Erica Cognolato  6 , Lino Nobili  6   7 , Domenico Tortora  8 , Carmen Barba  9   10 , Marianna Pommella  9   10 , Flavio Giordano  10   11 , Chiara Pastori  12 , Marcello Marchetti  13 , Rita Garbelli  12 , Mino Zucchelli  14 , Matteo Martinoni  14 , Lorenzo Ferri  15 , Matia Martucci  16   17 , Gianpiero Tamburrini  17   18 , Federico Bianchi  18 , Claudia Passamonti  19 , Giancarlo Di Gennaro  20 , Flavio Villani  21 , Laura Tassi  22 , Carlo Marras  4
Affiliations
Multicenter Study

Surgical and radiosurgical treatment of hypothalamic hamartoma: The Italian experience between 2011 and 2021

Michele Rizzi et al. Epilepsia Open. 2024 Aug.

Abstract

Objective: To investigate the Italian experience on the surgical and radiosurgical treatment of drug-resistant epilepsy due to hypothalamic hamartoma (HH) in the period 2011-2021 in six Italian epilepsy surgery centers, and to compare safety and efficacy profiles of the different techniques.

Methods: We collected pseudo-anonymized patient's data with at least 12 months of follow-up. Surgical outcome was defined according to Engel classification of seizure outcome. Univariate analysis was performed to assess the risk of post-operative seizures, categorized in dichotomous variable as favorable and unfavorable; explanatory variables were considered. Mann-Whitney or Chi-squared test were used to assess the presence of an association between variables (p < 0.05).

Results: Full presurgical and postoperative data about 42 patients from 6 epilepsy surgery centers were gathered. Engel class I was reached in the 65.8% and 66.6% of patients with gelastic and non-gelastic seizures, respectively. Other than daily non-gelastic seizures were associated with seizure freedom (p = 0.01), and the radiological type presented a trend toward significance (p = 0.12).

Significance: Endoscopic disconnection and laser interstitial thermal therapy are effective in the treatment of HH-related epilepsy, with a tolerable safety profile. Both gelastic and non-gelastic seizures can be treated, also in patients with a long history of seizures.

Plain language summary: This study collected data about 42 patients with HH-related epilepsies. Endoscopic disconnection and laser therapy are both effective and safe in the treatment of hypothalamic hamartoma-related epilepsies.

Keywords: endoscopic neurosurgery; epilepsy surgery; hypothalamic hamartoma; laser interstitial thermal therapy; stereotactic radiosurgery.

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Conflict of interest statement

The authors report no relevant conflict of interest. The authors confirm that they have read the journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

FIGURE 1
FIGURE 1
Trend on type of treatment, all the centers combined.
FIGURE 2a
FIGURE 2a
Trend on seizure outcome in patients with gelastic seizures (I = Engel Class I; non‐I = Engel Class II to IV).
FIGURE 2b
FIGURE 2b
Trend on seizure outcome in patients with non‐gelastic seizures (I = Engel Class I; non‐I = Engel Class II to IV).
See this image and copyright information in PMC

References

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    1. Engel JJ, Van Ness PC, Rasmussen TB, Ojemann LM. Outcome with respect to epileptic seizures. In: Engel J, editor. Surgical Treatment of the Epilepsies. New York: Raven Press, LTD; 1993. p. 609–621.

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