A novel use of the NeuroBlate SideFire probe for minimally invasive disconnection of a hypothalamic hamartoma in a child with gelastic seizures

J Neurosurg Pediatr. 2018 Mar;21(3):302-307. doi: 10.3171/2017.9.PEDS1747. Epub 2018 Jan 12.

Abstract

The authors describe the case of a 22-month-old boy who presented with gelastic seizures and developmental delay. Magnetic resonance imaging and video-electroencephalography monitoring revealed a primarily intraventricular hypothalamic hamartoma and gelastic seizures occurring 20-30 times daily. The patient was treated with various regimens of antiepileptic medications for 16 months, but the seizures remained medically intractable. At 3 years of age, he underwent stereotactic laser ablation with an aim of disconnection of the lesion. The procedure was performed with the NeuroBlate SideFire probe. To the authors' knowledge, this is the first reported use of this technology for this procedure and serves as proof of concept. There were no perioperative complications, and 2 years postprocedure, the patient remains seizure free with marked behavioral and cognitive improvements.

Keywords: = laser-induced thermal therapy; GS = gelastic seizure; HH = hypothalamic hamartoma; LITT; NeuroBlate; SRS = stereotactic radiosurgery; SRT = stereotactic radiofrequency thermocoagulation; epilepsy; gelastic seizure; hypothalamic hamartoma; laser-induced thermal therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Epilepsies, Partial / complications*
  • Epilepsies, Partial / diagnostic imaging
  • Hamartoma / diagnostic imaging*
  • Hamartoma / etiology*
  • Humans
  • Hypothalamic Diseases / diagnostic imaging*
  • Hypothalamic Diseases / etiology*
  • Image Processing, Computer-Assisted*
  • Infant
  • Magnetic Resonance Imaging*
  • Male
  • Software*
  • Video Recording

Supplementary concepts

  • Hypothalamic hamartomas