Adult-onset hypothalamic hamartoma: origin of epilepsy?

Area of Science:

• Neurology
• Pediatric Neurology
• Neurosurgery

Background:

• Hypothalamic hamartoma (HH) is a congenital, non-progressive hypothalamic lesion.
• HH can cause disabling symptoms including cognitive decline, psychiatric issues, and various seizure types.
• While common in children, adult-onset HH is exceptionally rare.

Purpose of the Study:

• To report a case of adult-onset hypothalamic hamartoma.
• To review and analyze global case reports and studies on HH.
• To highlight the clinical presentation and treatment outcomes of adult HH.

Main Methods:

• Case report of an adult patient with HH presenting with multiple seizure forms.
• Literature review and analysis of worldwide HH reports.
• Treatment involved stereotactic radiofrequency thermocoagulation and pharmacotherapy.

Main Results:

• The patient's seizures were effectively controlled post-treatment.
• Follow-up until October 2022 showed no seizure recurrence.
• Analysis of global data supports early intervention for better outcomes.

Conclusions:

• Epilepsy from HH can mimic temporal lobe seizures due to complex brain network involvement.
• Early treatment of HH is crucial for optimal epilepsy symptom control.
• Delayed treatment or longer disease duration may lead to increased complications.