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Hamartomas and epilepsy: clinical and imaging characteristics
1Department of Neurology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. diehlb@ccf.org
Seizure
|June 18, 2003
Summary
Cerebral hamartomas are rare brain lesions causing difficult-to-treat focal epilepsy. Imaging can be challenging, but these malformations are often linked to cortical dysplasia, highlighting their developmental origin.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Cerebral hamartomas are rare brain lesions characterized by disorganized mature neural elements.
- They represent an uncommon cause of medically intractable focal epilepsy.
Purpose of the Study:
- To present the clinical presentation and imaging findings of cerebral hamartomas.
- To investigate the association between hamartomas and epilepsy.
Main Methods:
- Review of clinical history and neurophysiological studies in 14 patients with pathologically confirmed hamartomas.
- Analysis of MRI findings in 10 patients.
Main Results:
- Hamartomas were most frequently found in the temporal and frontal lobes.
- Seizure semiology correlated with hamartoma location; EEG showed concordant abnormalities in many cases.
- MRI revealed T2 signal increase in all cases, with neocortical involvement and gray/white matter interface blurring in most.
Conclusions:
- Cerebral hamartomas are rare causes of severe epilepsy.
- Imaging features can mimic other developmental tumors.
- Hamartomas are often associated with microscopic cortical dysplasia, indicating a malformative etiology.