Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?

摘要: Successful treatment of hypothalamic hamartoma (HH) can result in the resolution its sequelae including epilepsy and rage attacks. Risks morbidity open surgical management this lesion have motivated development laser interstitial thermal therapy (LITT) as a less invasive approach to disease. Although overall risk would appear be lower, complications related LITT been reported, longer-term follow-up that is now possible after initial experience helps address question whether provides equivalent efficacy compared other options. We conducted retrospective analysis clinical outcomes eight patients undergoing for HH at our center using Visualase/Medtronic device. Five had refractory epilepsy, one attacks, two both. also published seizure-free over time complication rates different interventional approaches due craniotomy, neuroendoscopic, radiosurgical, radiofrequency approaches. With mean 19.1 months series patients, six seven achieved seizure freedom, whereas patient with attacks only did not improvement his symptoms. A length hospital stay 2.6 days reflects low rapid postoperative recuperation LITT. Considering reported case reports, freedom rate 21 25 superior cases treated by stereotactic radiosurgery (SRS), or neuroendoscopy, comparable ablation. The cumulative supports relatively lower operative than more good better craniotomy procedures SRS. appears approaches, their avoidance should considered carefully.