Surgical outcomes of patients with hypothalamic hamartoma treated at preschool age

Shirozu Hiroshi, Masuda Hiroshi, Kameyama Shigeki

doi:10.34544/jspn.47.4_377

<p>The feasibility of an early indication of stereotactic radiofrequency thermocoagulation (SRT) in patients with epilepsy due to hypothalamic hamartoma (HH) was evaluated. This study included patients who underwent SRT before they were 18 years of age. The study sample was divided into the preschool (age < 5 years; n=73) and school (age > 6 years; n=79) groups to allow comparison. HH observed in the preschool group tended to be larger and more complex in shape, necessitating large-scale surgeries and more frequent reoperation compared to the school group. However, no differences in the rates of complications were observed between the two groups. The freedom rates of gelastic seizures were significantly lower in the preschool group (83.6%) compared to the school group (94.9%), while nongelastic seizures did not differ significantly between the groups. Developmental improvements were observed in 38.1% of the preschool group; this was significantly lower than the school group (61.3%). The findings of this study suggest that although an early indication of surgery may be favorable and safe, the surgical benefits are relatively insufficient than delayed surgery in pediatric patients. Therefore, the severity of seizures or cognitive symptoms of a patient should be considered when determining the timing of the surgery.</p>

Surgical outcomes of patients with hypothalamic hamartoma treated at preschool age

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