Objective: To investigate the Italian experience on the surgical and radiosurgical treatment of drug-resistant epilepsy due to hypothalamic hamartoma (HH) in the period 2011-2021 in six Italian epilepsy surgery centers, and to compare safety and efficacy profiles of the different techniques. Methods: We collected pseudo-anonymized patient's data with at least 12 months of follow-up. Surgical outcome was defined according to Engel classification of seizure outcome. Univariate analysis was performed to assess the risk of post-operative seizures, categorized in dichotomous variable as favorable and unfavorable; explanatory variables were considered. Mann-Whitney or Chi-squared test were used to assess the presence of an association between variables (p < 0.05). Results: Full presurgical and postoperative data about 42 patients from 6 epilepsy surgery centers were gathered. Engel class I was reached in the 65.8% and 66.6% of patients with gelastic and non-gelastic seizures, respectively. Other than daily non-gelastic seizures were associated with seizure freedom (p = 0.01), and the radiological type presented a trend toward significance (p = 0.12). Significance: Endoscopic disconnection and laser interstitial thermal therapy are effective in the treatment of HH-related epilepsy, with a tolerable safety profile. Both gelastic and non-gelastic seizures can be treated, also in patients with a long history of seizures. Plain language summary: This study collected data about 42 patients with HH-related epilepsies. Endoscopic disconnection and laser therapy are both effective and safe in the treatment of hypothalamic hamartoma-related epilepsies.
Surgical and radiosurgical treatment of hypothalamic hamartoma: The Italian experience between 2011 and 2021 / Rizzi, Michele; Consales, Alessandro; Tramacere, Irene; De Benedictis, Alessandro; Bua, Antonella; Specchio, Nicola; De Palma, Luca; Cognolato, Erica; Nobili, Lino; Tortora, Domenico; Barba, Carmen; Pommella, Marianna; Giordano, Flavio; Pastori, Chiara; Marchetti, Marcello; Garbelli, Rita; Zucchelli, Mino; Martinoni, Matteo; Ferri, Lorenzo; Martucci, Matia; Tamburrini, Gianpiero; Bianchi, Federico; Passamonti, Claudia; Di Gennaro, Giancarlo; Villani, Flavio; Tassi, Laura; Marras, Carlo. - In: EPILEPSIA OPEN. - ISSN 2470-9239. - ELETTRONICO. - (2024), pp. 0-0. [10.1002/epi4.12989]
Surgical and radiosurgical treatment of hypothalamic hamartoma: The Italian experience between 2011 and 2021
Barba, CarmenWriting – Review & Editing
;Pommella, MariannaData Curation
;Giordano, FlavioData Curation
;
2024
Abstract
Objective: To investigate the Italian experience on the surgical and radiosurgical treatment of drug-resistant epilepsy due to hypothalamic hamartoma (HH) in the period 2011-2021 in six Italian epilepsy surgery centers, and to compare safety and efficacy profiles of the different techniques. Methods: We collected pseudo-anonymized patient's data with at least 12 months of follow-up. Surgical outcome was defined according to Engel classification of seizure outcome. Univariate analysis was performed to assess the risk of post-operative seizures, categorized in dichotomous variable as favorable and unfavorable; explanatory variables were considered. Mann-Whitney or Chi-squared test were used to assess the presence of an association between variables (p < 0.05). Results: Full presurgical and postoperative data about 42 patients from 6 epilepsy surgery centers were gathered. Engel class I was reached in the 65.8% and 66.6% of patients with gelastic and non-gelastic seizures, respectively. Other than daily non-gelastic seizures were associated with seizure freedom (p = 0.01), and the radiological type presented a trend toward significance (p = 0.12). Significance: Endoscopic disconnection and laser interstitial thermal therapy are effective in the treatment of HH-related epilepsy, with a tolerable safety profile. Both gelastic and non-gelastic seizures can be treated, also in patients with a long history of seizures. Plain language summary: This study collected data about 42 patients with HH-related epilepsies. Endoscopic disconnection and laser therapy are both effective and safe in the treatment of hypothalamic hamartoma-related epilepsies.File | Dimensione | Formato | |
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Epilepsia Open - 2024 - Rizzi - Surgical and radiosurgical treatment of hypothalamic hamartoma The Italian experience.pdf
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