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Updated: Jun 4, 2025
Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
Published on: April 12, 2024
MRgFUS disconnection surgery for hypothalamic hamartoma-related epilepsy: case report and literature review
Giuseppe K Ricciardi1, Fabio Paio2,3, Cecilia Zivelonghi4
1Neuroradiology Unit, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Background:
Drug-resistant epilepsy (DRE) secondary to hypothalamic hamartoma (HH) often requires surgical resection or stereotactic radiosurgery, which frequently fail to provide satisfactory outcomes and are associated with severe side effects. Magnetic resonance-guided focused ultrasound (MRgFUS) may represent a minimally invasive surgical approach to HH by offering precise thermal ablation of sub-millimetric brain targets while sparing surrounding structures.
Methods:
We present the case of a 19-year-old man with HH-associated DRE, who was successfully treated with MRgFUS. The procedure resulted in effective ablation of the hypothalamic interface of the HH, disconnecting the epileptogenic lesion from the surrounding brain tissue. We also reviewed the literature on MRgFUS for DRE.
Results:
The patient experienced a complete resolution of seizures and significant improvements in social and occupational functioning over an 18-month follow-up period. No neurological, cognitive, or endocrinological adverse effects were observed.
Conclusion:
Our case report and literature review suggest that MRgFUS may achieve adequate seizure control in DRE associated with HH without adverse effects. While MRgFUS shows promise for other forms of DRE, data remain preliminary, and some safety concerns persist. Further studies with long-term follow-up are warranted to better support the use of MRgFUS in DRE.
