Successful Endoscopic Disconnection for Hypothalamic Hamartomas in a Child with Gelastic Seizures: An Unusual Case in a Resource-Scare Setting

Abstract

He Van Dong,1,* Van Dinh Tran,1,* Dinh-Hoa Nguyen,2– 4,* Hoe Van Vu,5 Tuan Anh Nguyen,6 Ha Ngoc Thi Doan,7 Hoang-Long Vo7,8 1Department of Neurosurgery I, Viet Duc University Hospital, Hanoi 100000, Vietnam; 2Institute of Orthopedic Trauma, Viet Duc University Hospital, Hanoi 100000, Vietnam; 3Social Affair Department, Viet Duc University Hospital, Hanoi 100000, Vietnam; 4Department of Surgery, Hai Duong Medical Technical University, Hai Duong 170000, Vietnam; 5Department of Neurosurgery, 103 Military Hospital, Hanoi 100000, Vietnam; 6Department of Neurology, Viet Duc University Hospital, Hanoi 100000, Vietnam; 7Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; 8Institute of Health Economics and Technology, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Hoang-Long VoInstitute for Preventive Medicine and Public Health, Hanoi Medical University, No. 01 Ton That Tung Street, Dong Da, Hanoi 100000, VietnamTel [phone]Fax [phone]Email [email protected] Ngoc Thi Doan Email [email protected]: Although the endoscopic disconnection surgery for the hamartomas was previously shown as a safe and effective treatment strategy in eliminating gelastic epilepsy, to date, there was no convincing evidence with this procedure in the resource-scare settings. We discuss an unusual case of a 7-year-old child who suffered from pharmacoresistant gelastic seizures was surgically treated with the endoscopic disconnection of the hypothalamic hamartomas. The patient underwent endoscopic surgery through the left ventricle approach to disconnect the lesion of the hypothalamus. Immediately after surgery, the patient’s clinical laughter was eliminated with no complications. From the initial experience at our center, successful outcome of this case contributes to supporting the solid evidence in choosing the right treatment approach for the hypothalamus in subsequent cases, towards not only Vietnam but also the countries having similar resource-scare conditions.Keywords: hypothalamic hamartomas, gelastic seizure, drug-resistant epilepsy, endoscopic surgical disconnection

Keywords

• hypothalamic hamartomas
• gelastic seizure
• drug-resistant epilepsy
• endoscopic surgical disconnection