Magnetic resonance–guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery: a case report

• DOI: 10.1007/s00701-020-04468-6
• Publication Date: 2020-07-02T06:49:30Z
• Authors: Toshio Yamaguchi; Tomokatu Hori; Hiroki Hori; Masahito Takasaki; Keiichi Abe; Takaomi Taira; Kenji Ishii; Kazuo Watanabe
• Keywords: Gelastic seizure; Hamartoma; Neuroradiology; Disconnection; Interventional radiology

We report the case of a patient with hypothalamic hamartoma (HH) who was successfully treated with magnetic resonance-guided focused ultrasound (MRgFUS) for ablation as a disconnection surgery. A 26-year-old man with gelastic epilepsy had been diagnosed with HH at 3 years of age, and antiepileptic drugs were administered due to worsening episodes. Magnetic resonance imaging showed a sessile parahypothalamic hamartoma and MRgFUS ablation was performed, creating an oval-shaped lesion at the boundary area of the HH. Dramatic improvements in seizure symptoms were noted, and he was seizure-free on decreased antiepileptic drugs without any adverse events over the 1-year follow-up period.