Surgical treatment of epilepsy caused by hypothalamic hamartomas

Objective To investigate the surgical treatment and its effect in children with hypothalamic hamartoma with epilepsy as the main manifestation in order to provide basis for the treatment of the disease. Methods The clinical manifestations, operation methods and effects in 20 children with hypothalamic hamartoma with epilepsy as the main manifestation admitted to the Department of Pediatric Surgery, the First Hospital of Peking University from March 2012 to December 2015 were analyzed retrospectively. Seventeen children underwent right frontal craniotomy in stage I. The hypothalamic hamartomas were resected via the transcallosal transseptal interforniceal approach. Two were treated with staging operations combined with interhemispheric translamina terminalis approach and 1 hamartoma posterior to the pituitary stalk was resected via the pterional approach. Results The hypothalamic hamartomas of 11 children were resected totally, 6 were resected near totally, and 3 were resected subtotally. Postoperative seizures disappeared in all children. All Engel classification reached grade I. Twelve children experienced transient high fever after procedure, 1 experienced temporary memory deficiency, 3 experienced polyuria, 1 had hypernatremia, 10 had hyponatremia (including 3 hyponatremia convulsions), and 2 had hyperphagia. Conclusion For children with hypothalamic hamartoma with epilepsy as the main clinical manifestation, early surgical treatment is safe and effective. Key words: Hypothalamic neoplasms; Hamartoma; Neurosurgical procedures; Postoperative complications; Child