One-Stage High-Density Focal Stereo-Array SEEG-Guided Radiofrequency Thermocoagulation for the Treatment of Pediatric Giant Hypothalamic Hamartomas

Wang, Min; Zhou, Yuanfeng; Zhang, Yi; Wei, Shi; Zhou, Shuizhen; Wang, Yi; Li, Hao; Zhao, Rui

doi:10.3389/fneur.2020.00965

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…A patient from the study by Du et al 29 was excluded because of the absence of seizures at HH presentation. Finally, 15 studies 10,16,17,[26][27][28][29][30][31][32][33][34][35][36][37] enter the study. The study selection flowchart is presented in Fig.…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Iranmehr

Ohadi

Chavoshi

et al. 2022

Neurosurgical Focus

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OBJECTIVE Hypothalamic hamartoma (HH) is a rare, nonmalignant, heterotopic developmental malformation that consists of a mixture of normal neurons and glial cells. Resection of HHs has been associated with high rates of mortality and morbidity. Therefore, minimally invasive ablation methods could be the best treatment option for HH. The most frequently used minimally invasive options for HH ablation are radiofrequency thermocoagulation (RFT), laser ablation (LA), and stereotactic radiosurgery. METHODS To investigate three minimally invasive procedures in the treatment of refractory seizures related to HH, the authors conducted a systematic search in March 2022 in the MEDLINE, Embase, Scopus, and Web of Science databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seizure freedom was the primary outcome of interest. The authors defined seizure freedom as Engel class I or International League Against Epilepsy class 1 or 2 or as the reported term “seizure freedom.” The secondary outcome was long-term complications reported in studies. Both random- and fixed-effects models were used to calculate the pooled proportion of seizure freedom and complication rate with 95% confidence intervals. A modified version of the Joanna Briggs Institute (JBI) Critical Appraisal to assess the risk of bias was used. RESULTS The authors included 15 studies with 422 patients (RFT, n = 190; LA, n = 171; and Gamma Knife Radiosurgery [GKRS], n = 61). Generally, the mean incidences of overall seizure freedom after minimally invasive procedures were 77% (95% CI 0.74–0.81) and 68% (95% CI 0.57–0.79) using fixed- and random-effects models, respectively. The mean incidence of overall seizure freedom after RFT was 69% (95% CI 0.63–0.75), and the mean incidences of overall seizure freedom after LA and GKRS were 87% (95% CI 0.82–0.92) and 44% (95% CI 0.32–0.57), respectively. The total complication rate with minimally invasive procedures was 13% (95% CI 0.01–0.26). The complication rate in each treatment was as follows: 5% (95% CI 0.0–0.12) for RFT, 20% (95% CI 0.0–0.47) for LA, and 22% (95% CI 0–0.65) for GKRS. Meta-regression analysis showed an association between older age and higher complication rates in the LA group. CONCLUSIONS In this meta-analysis, LA showed superiority in seizure freedom over the other two methods. The complication rate associated with RFT was less than those in the other two methods; however, this difference was not statistically significant.

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Section: Resultsmentioning

confidence: 99%

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Iranmehr

Ohadi

Chavoshi

et al. 2022

Neurosurgical Focus

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“…In addition to craniotomy, Gamma Knife surgery has also exhibited a certain degree of efficacy for refractory epilepsy caused by HH (10). Recently, HH therapy has reached a new stage with the growth of the epileptic network theory and minimally invasive techniques such as stereoelectroencephalography (SEEG), radiofrequency thermocoagulation (RF-TC) (11,12), and magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRg-LiTT) (13)(14)(15). Many institutions, including Xuanwu Hospital of Capital Medical University, have conducted in-depth research on HH (1,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Advances in hypothalamic hamartoma research over the past 30 years (1992–2021): a bibliometric analysis

et al. 2023

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BackgroundHypothalamic hamartoma (HH) is a rare intracranial disease whose manifestations include gelastic seizures and precocious puberty. The diagnosis and treatment of HH have changed substantially over the past three decades as medical care has improved. Bibliometrics can reveal the evolution and development of a scientific field.MethodsDocuments on HH were retrieved from the Web of Science Core Collection (WoSCC) database on September 8, 2022. The search terms were as follows: “hypothalamic hamartoma” or “hamartoma of the hypothalamus” or “hypothalamic hamartomas.” The types of documents were restricted to articles, case reports, and reviews. VOSviewer, CiteSpace, and the R package “bibliometrix” were used for a bibliometric analysis.ResultsA total of 667 independent documents on HH were obtained from the WoSCC database. The most common types of documents were articles (n = 498, 75%) and reviews (n = 103, 15%). The number of annual publications fluctuated but showed an upward trend overall, and the annual growth rate was 6.85%. The cumulative publication data indicated that the most influential journals in the HH field include Epilepsia, Epileptic Disorders, Child’s Nervous System, Neurosurgery, and the Journal of Neurosurgery. Kerrigan JF, Ng YT, Rekate HL, Regis J, and Kameyama S were among the most prominent authors in the field of HH, with numerous publications and citations. American research institutions, especially the Barrow Neurological Institute, occupied a pivotal position in HH research. Other countries and institutions were catching up and producing considerable research results. Research on HH has steadily switched its emphasis from Pallister-Hall syndrome (PHS) and precocious puberty to epilepsy and new diagnostic and therapeutic techniques, including Gamma Knife, laser ablation, and interstitial thermal therapy.ConclusionHH remains a special neurological disease with significant research prospects. The development of novel technologies, including MRI-guided laser-induced thermal therapy (MRg-LiTT) and stereotactic radiofrequency thermocoagulation (RF-TC), has enabled the efficient treatment of gelastic seizures in HH while minimizing the risks associated with craniotomies. Through bibliometric analysis, this study points out the direction for future HH research.

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“…A large-sampled prospective study reported a seizure-free rate of 7% and responder rate (defined as >50% decreased seizure frequency) of 48% at 1 year follow-up with permanent and transient side effect rates of 1.1 and 2.4%, respectively ( Bourdillon et al, 2017 ). The therapeutic effects of SEEG-guided RFTC in new specific indications have increasingly been identified, including hypothalamic hamartomas and periventricular nodular heterotopia ( Mirandola et al, 2017 ; Wei et al, 2018 ; Wang et al, 2020 ). And SEEG-guided RFTC has also been proven to be effective in treating insular epilepsy and malformation of cortical development (MCD)-related epilepsy ( Catenoix et al, 2015 ; Mullatti et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Utility of hybrid PET/MRI in stereoelectroencephalography guided radiofrequency thermocoagulation in MRI negative epilepsy patients

Li,

Zhang,

Lin

et al. 2023

Front. Neurosci.

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IntroductionHybrid positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel advanced non-invasive presurgical examination tool for patients with drug-resistant epilepsy (DRE). This study aims to evaluate the utility of PET/MRI in patients with DRE who undergo stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RFTC).MethodsThis retrospective study included 27 patients with DRE who underwent hybrid PET/MRI and SEEG-guided RFTC. Surgery outcome was assessed using a modified Engel classification, 2 years after RFTC. Potential areas of the seizure onset zone (SOZ) were identified on PET/MRI and confirmed by SEEG.ResultsFifteen patients (55%) became seizure-free after SEEG-guided RFTC. Engel class II, III, and IV were achieved in six, two, and four patients, respectively at the 2 years follow-up. MRI was negative in 23 patients and structural abnormalities were found in four patients. Hybrid PET/MRI contributed to the identification of new structural or metabolic lesions in 22 patients. Concordant results between PET/MRI and SEEG were found in 19 patients in the identification of SOZ. Among the patients with multifocal onset, seizure-free status was achieved in 50% (6/12).ConclusionSEEG-guided RFTC is an effective and safe treatment for drug-resistant epilepsy. Hybrid PET/MRI serves as a useful tool for detecting the potential SOZs in MRI-negative patients and guide the implantation of SEEG electrodes. Patients with multifocal epilepsy may also benefit from this palliative treatment.

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One-Stage High-Density Focal Stereo-Array SEEG-Guided Radiofrequency Thermocoagulation for the Treatment of Pediatric Giant Hypothalamic Hamartomas

Cited by 3 publications

References 35 publications

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Advances in hypothalamic hamartoma research over the past 30 years (1992–2021): a bibliometric analysis

Utility of hybrid PET/MRI in stereoelectroencephalography guided radiofrequency thermocoagulation in MRI negative epilepsy patients

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