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Updated: Jul 16, 2025
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Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
Published on: April 12, 2024
372
Hypothalamic hamartoma surgery in a setting with limited resources
Ali A Asadi-Pooya1, Mohamad S Masoudi2, Bita Hashemi2
1Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Epilepsy & Behavior : E&B
|September 16, 2023
Summary
Hypothalamic hamartoma (HH) surgery is feasible in resource-limited settings. Open disconnection and resection techniques led to significant seizure reduction or freedom in most patients, demonstrating the value of collaborative epilepsy and neurosurgery teams.
Area of Science:
- Neurosurgery
- Epileptology
- Medical Devices
Background:
- Initiation of a surgical program for hypothalamic hamartoma (HH) in Shiraz, Iran, in 2020.
- Limited availability of minimally invasive techniques necessitated the use of open disconnection and resection surgery.
- This case series presents the outcomes of the HH surgery program at the Shiraz Epilepsy Center.
Purpose of the Study:
- To evaluate the feasibility and outcomes of open surgical techniques for hypothalamic hamartoma (HH) in a resource-limited epilepsy center.
- To assess seizure control, complications, and patient satisfaction following HH surgery.
Main Methods:
- Retrospective case series of seven patients diagnosed with hypothalamic hamartoma (HH) and drug-resistant epilepsy.
- Patients underwent open disconnection and resection surgery between October 2020 and January 2023 at Namazi Hospital, Shiraz, Iran.
- Outcomes assessed included seizure frequency, complications, and parent satisfaction.
Main Results:
- All seven patients experienced gelastic seizures.
- Four patients (57%) had total resection, and three (43%) had partial resection.
- Three patients (43%) achieved seizure freedom, and three (43%) had >50% seizure reduction.
- One patient (14.3%) experienced hemiparesis; mortality was zero. Five parents (71%) reported satisfaction.
Conclusions:
- Surgical treatment for hypothalamic hamartoma (HH) is achievable in centers with limited resources.
- Close collaboration between epileptology and neurosurgery teams is crucial for success.
- Careful planning tailored to team expertise and available resources is essential.
