Skip to main content
Erschienen in: Child's Nervous System 4/2009

01.04.2009 | Review Paper

A review on the management of epilepsy associated with hypothalamic hamartomas

verfasst von: James L. Frazier, C. Rory Goodwin, Edward S. Ahn, George I. Jallo

Erschienen in: Child's Nervous System | Ausgabe 4/2009

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Hypothalamic hamartomas are rare congenital malformations located in the region of the tuber cinereum and third ventricle. Patients may be asymptomatic, but the usual presentation is gelastic seizures, precocious puberty, and/or developmental delay.

Clinical presentation

Without surgical intervention, the gelastic seizures, which are typically present in childhood, may progress to other seizure types, including generalized epilepsy, and are generally refractory to antiepileptic drugs.

Summary

This review will discuss the clinical and electrophysiologic aspects of these lesions, as well as treatment options, including surgery, endoscopy, and radiosurgery.
Literatur
1.
Zurück zum Zitat Akai T, Okamoto K, Iizuka H, Kakinuma H, Nojima T (2002) Treatments of hamartoma with neuroendoscopic surgery and stereotactic radiosurgery: a case report. Minim Invasive Neurosurg 45:235–239CrossRefPubMed Akai T, Okamoto K, Iizuka H, Kakinuma H, Nojima T (2002) Treatments of hamartoma with neuroendoscopic surgery and stereotactic radiosurgery: a case report. Minim Invasive Neurosurg 45:235–239CrossRefPubMed
2.
Zurück zum Zitat Arita K, Ikawa F, Kurisu K, Sumida M, Harada K, Uozumi T, Monden S, Yoshida J, Nishi Y (1999) The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. J Neurosurg 91:212–220CrossRefPubMed Arita K, Ikawa F, Kurisu K, Sumida M, Harada K, Uozumi T, Monden S, Yoshida J, Nishi Y (1999) The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. J Neurosurg 91:212–220CrossRefPubMed
3.
Zurück zum Zitat Arita K, Kurisu K, Iida K, Hanaya R, Akimitsu T, Hibino S, Pant B, Hamasaki M, Shinagawa S (1998) Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma. Case report. J Neurosurg 89:645–648CrossRefPubMed Arita K, Kurisu K, Iida K, Hanaya R, Akimitsu T, Hibino S, Pant B, Hamasaki M, Shinagawa S (1998) Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma. Case report. J Neurosurg 89:645–648CrossRefPubMed
4.
Zurück zum Zitat Arzimanoglou AA, Hirsch E, Aicardi J (2003) Hypothalamic hamartoma and epilepsy in children: illustrative cases of possible evolutions. Epileptic Disord 5:187–199PubMed Arzimanoglou AA, Hirsch E, Aicardi J (2003) Hypothalamic hamartoma and epilepsy in children: illustrative cases of possible evolutions. Epileptic Disord 5:187–199PubMed
5.
Zurück zum Zitat Barajas MA, Ramirez-Guzman MG, Rodriguez-Vazquez C, Toledo-Buenrostro V, Cuevas-Solorzano A, Rodriguez-Hernandez G (2005) Gamma knife surgery for hypothalamic hamartomas accompanied by medically intractable epilepsy and precocious puberty: experience in Mexico. J Neurosurg 102(Suppl):53–55CrossRefPubMed Barajas MA, Ramirez-Guzman MG, Rodriguez-Vazquez C, Toledo-Buenrostro V, Cuevas-Solorzano A, Rodriguez-Hernandez G (2005) Gamma knife surgery for hypothalamic hamartomas accompanied by medically intractable epilepsy and precocious puberty: experience in Mexico. J Neurosurg 102(Suppl):53–55CrossRefPubMed
6.
Zurück zum Zitat Berkovic SF, Andermann F, Melanson D, Ethier RE, Feindel W, Gloor P (1988) Hypothalamic hamartomas and ictal laughter: evolution of a characteristic epileptic syndrome and diagnostic value of magnetic resonance imaging. Ann Neurol 23:429–439CrossRefPubMed Berkovic SF, Andermann F, Melanson D, Ethier RE, Feindel W, Gloor P (1988) Hypothalamic hamartomas and ictal laughter: evolution of a characteristic epileptic syndrome and diagnostic value of magnetic resonance imaging. Ann Neurol 23:429–439CrossRefPubMed
7.
Zurück zum Zitat Berkovic SF, Arzimanoglou A, Kuzniecky R, Harvey AS, Palmini A, Andermann F (2003) Hypothalamic hamartoma and seizures: a treatable epileptic encephalopathy. Epilepsia 44:969–973CrossRefPubMed Berkovic SF, Arzimanoglou A, Kuzniecky R, Harvey AS, Palmini A, Andermann F (2003) Hypothalamic hamartoma and seizures: a treatable epileptic encephalopathy. Epilepsia 44:969–973CrossRefPubMed
8.
Zurück zum Zitat Berkovic SF, Kuzniecky RI, Andermann F (1997) Human epileptogenesis and hypothalamic hamartomas: new lessons from an experiment of nature. Epilepsia 38:1–3CrossRefPubMed Berkovic SF, Kuzniecky RI, Andermann F (1997) Human epileptogenesis and hypothalamic hamartomas: new lessons from an experiment of nature. Epilepsia 38:1–3CrossRefPubMed
9.
Zurück zum Zitat Boyko OB, Curnes JT, Oakes WJ, Burger PC (1991) Hamartomas of the tuber cinereum: CT, MR, and pathologic findings. AJNR Am J Neuroradiol 12:309–314PubMed Boyko OB, Curnes JT, Oakes WJ, Burger PC (1991) Hamartomas of the tuber cinereum: CT, MR, and pathologic findings. AJNR Am J Neuroradiol 12:309–314PubMed
10.
Zurück zum Zitat Brandberg G, Raininko R, Eeg-Olofsson O (2004) Hypothalamic hamartoma with gelastic seizures in Swedish children and adolescents. Eur J Paediatr Neurol 8:35–44CrossRefPubMed Brandberg G, Raininko R, Eeg-Olofsson O (2004) Hypothalamic hamartoma with gelastic seizures in Swedish children and adolescents. Eur J Paediatr Neurol 8:35–44CrossRefPubMed
11.
Zurück zum Zitat Breningstall GN (1985) Gelastic seizures, precocious puberty, and hypothalamic hamartoma. Neurology 35:1180–1183PubMed Breningstall GN (1985) Gelastic seizures, precocious puberty, and hypothalamic hamartoma. Neurology 35:1180–1183PubMed
12.
Zurück zum Zitat Cascino GD, Andermann F, Berkovic SF, Kuzniecky RI, Sharbrough FW, Keene DL, Bladin PF, Kelly PJ, Olivier A, Feindel W (1993) Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology 43:747–750PubMed Cascino GD, Andermann F, Berkovic SF, Kuzniecky RI, Sharbrough FW, Keene DL, Bladin PF, Kelly PJ, Olivier A, Feindel W (1993) Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology 43:747–750PubMed
13.
Zurück zum Zitat Choi JU, Yang KH, Kim TG, Chang JH, Chang JW, Lee BI, Kim DS (2004) Endoscopic disconnection for hypothalamic hamartoma with intractable seizure. Report of four cases. J Neurosurg 100:506–511PubMed Choi JU, Yang KH, Kim TG, Chang JH, Chang JW, Lee BI, Kim DS (2004) Endoscopic disconnection for hypothalamic hamartoma with intractable seizure. Report of four cases. J Neurosurg 100:506–511PubMed
14.
Zurück zum Zitat Coulter D (1997) Thalamocortical anatomy and physiology. In: Engel J, Pedley T (eds) Epilepsy: a comprehensive textbook. Lippincott-Raven, Philadelphia, pp 341–351 Coulter D (1997) Thalamocortical anatomy and physiology. In: Engel J, Pedley T (eds) Epilepsy: a comprehensive textbook. Lippincott-Raven, Philadelphia, pp 341–351
15.
Zurück zum Zitat Daly DD, Mulder DW (1957) Gelastic epilepsy. Neurology 7:189–192PubMed Daly DD, Mulder DW (1957) Gelastic epilepsy. Neurology 7:189–192PubMed
16.
Zurück zum Zitat Debeneix C, Bourgeois M, Trivin C, Sainte-Rose C, Brauner R (2001) Hypothalamic hamartoma: comparison of clinical presentation and magnetic resonance images. Horm Res 56:12–18CrossRefPubMed Debeneix C, Bourgeois M, Trivin C, Sainte-Rose C, Brauner R (2001) Hypothalamic hamartoma: comparison of clinical presentation and magnetic resonance images. Horm Res 56:12–18CrossRefPubMed
17.
Zurück zum Zitat Delalande O, Fohlen M (2003) Disconnecting surgical treatment of hypothalamic hamartoma in children and adults with refractory epilepsy and proposal of a new classification. Neurol Med Chir (Tokyo) 43:61–68CrossRef Delalande O, Fohlen M (2003) Disconnecting surgical treatment of hypothalamic hamartoma in children and adults with refractory epilepsy and proposal of a new classification. Neurol Med Chir (Tokyo) 43:61–68CrossRef
18.
Zurück zum Zitat Deonna T, Ziegler AL (2000) Hypothalamic hamartoma, precocious puberty and gelastic seizures: a special model of “epileptic” developmental disorder. Epileptic Disord 2:33–37PubMed Deonna T, Ziegler AL (2000) Hypothalamic hamartoma, precocious puberty and gelastic seizures: a special model of “epileptic” developmental disorder. Epileptic Disord 2:33–37PubMed
19.
20.
Zurück zum Zitat DiFazio MP, Davis RG (2000) Utility of early single photon emission computed tomography (SPECT) in neonatal gelastic epilepsy associated with hypothalamic hamartoma. J Child Neurol 15:414–417CrossRefPubMed DiFazio MP, Davis RG (2000) Utility of early single photon emission computed tomography (SPECT) in neonatal gelastic epilepsy associated with hypothalamic hamartoma. J Child Neurol 15:414–417CrossRefPubMed
21.
Zurück zum Zitat Dunoyer C, Ragheb J, Resnick T, Alvarez L, Jayakar P, Altman N, Wolf A, Duchowny M (2002) The use of stereotactic radiosurgery to treat intractable childhood partial epilepsy. Epilepsia 43:292–300CrossRefPubMed Dunoyer C, Ragheb J, Resnick T, Alvarez L, Jayakar P, Altman N, Wolf A, Duchowny M (2002) The use of stereotactic radiosurgery to treat intractable childhood partial epilepsy. Epilepsia 43:292–300CrossRefPubMed
22.
Zurück zum Zitat Feiz-Erfan I, Horn EM, Rekate HL, Spetzler RF, Ng YT, Rosenfeld JV, Kerrigan JF 3rd (2005) Surgical strategies for approaching hypothalamic hamartomas causing gelastic seizures in the pediatric population: transventricular compared with skull base approaches. J Neurosurg 103:325–332PubMed Feiz-Erfan I, Horn EM, Rekate HL, Spetzler RF, Ng YT, Rosenfeld JV, Kerrigan JF 3rd (2005) Surgical strategies for approaching hypothalamic hamartomas causing gelastic seizures in the pediatric population: transventricular compared with skull base approaches. J Neurosurg 103:325–332PubMed
23.
Zurück zum Zitat Fohlen M, Lellouch A, Delalande O (2003) Hypothalamic hamartoma with refractory epilepsy: surgical procedures and results in 18 patients. Epileptic Disord 5:267–273PubMed Fohlen M, Lellouch A, Delalande O (2003) Hypothalamic hamartoma with refractory epilepsy: surgical procedures and results in 18 patients. Epileptic Disord 5:267–273PubMed
24.
Zurück zum Zitat Frattali CM, Liow K, Craig GH, Korenman LM, Makhlouf F, Sato S, Biesecker LG, Theodore WH (2001) Cognitive deficits in children with gelastic seizures and hypothalamic hamartoma. Neurology 57:43–46PubMed Frattali CM, Liow K, Craig GH, Korenman LM, Makhlouf F, Sato S, Biesecker LG, Theodore WH (2001) Cognitive deficits in children with gelastic seizures and hypothalamic hamartoma. Neurology 57:43–46PubMed
25.
Zurück zum Zitat Freeman JL, Coleman LT, Wellard RM, Kean MJ, Rosenfeld JV, Jackson GD, Berkovic SF, Harvey AS (2004) MR imaging and spectroscopic study of epileptogenic hypothalamic hamartomas: analysis of 72 cases. AJNR Am J Neuroradiol 25:450–462PubMed Freeman JL, Coleman LT, Wellard RM, Kean MJ, Rosenfeld JV, Jackson GD, Berkovic SF, Harvey AS (2004) MR imaging and spectroscopic study of epileptogenic hypothalamic hamartomas: analysis of 72 cases. AJNR Am J Neuroradiol 25:450–462PubMed
26.
Zurück zum Zitat Freeman JL, Harvey AS, Rosenfeld JV, Wrennall JA, Bailey CA, Berkovic SF (2003) Generalized epilepsy in hypothalamic hamartoma: evolution and postoperative resolution. Neurology 60:762–767PubMed Freeman JL, Harvey AS, Rosenfeld JV, Wrennall JA, Bailey CA, Berkovic SF (2003) Generalized epilepsy in hypothalamic hamartoma: evolution and postoperative resolution. Neurology 60:762–767PubMed
27.
Zurück zum Zitat Fujimoto Y, Kato A, Saitoh Y, Ninomiya H, Imai K, Sakakibara RI, Maruno M, Kishima H, Yoshimura K, Hasegawa H, Yoshimine T (2003) Stereotactic radiofrequency ablation for sessile hypothalamic hamartoma with an image fusion technique. Acta Neurochir (Wien) 145:697–700, discussion 700-691CrossRef Fujimoto Y, Kato A, Saitoh Y, Ninomiya H, Imai K, Sakakibara RI, Maruno M, Kishima H, Yoshimura K, Hasegawa H, Yoshimine T (2003) Stereotactic radiofrequency ablation for sessile hypothalamic hamartoma with an image fusion technique. Acta Neurochir (Wien) 145:697–700, discussion 700-691CrossRef
28.
Zurück zum Zitat Fukuda M, Kameyama S, Wachi M, Tanaka R (1999) Stereotaxy for hypothalamic hamartoma with intractable gelastic seizures: technical case report. Neurosurgery 44:1347–1350CrossRefPubMed Fukuda M, Kameyama S, Wachi M, Tanaka R (1999) Stereotaxy for hypothalamic hamartoma with intractable gelastic seizures: technical case report. Neurosurgery 44:1347–1350CrossRefPubMed
29.
Zurück zum Zitat Gore PA, Nakaji P, Deshmukh V, Rekate HL (2006) Synchronous endoscopy and microsurgery: a novel strategy to approach complex ventricular lesions. Report of three cases. J Neurosurg 105:485–489CrossRefPubMed Gore PA, Nakaji P, Deshmukh V, Rekate HL (2006) Synchronous endoscopy and microsurgery: a novel strategy to approach complex ventricular lesions. Report of three cases. J Neurosurg 105:485–489CrossRefPubMed
30.
Zurück zum Zitat Harvey AS, Freeman JL (2007) Epilepsy in hypothalamic hamartoma: clinical and EEG features. Semin Pediatr Neurol 14:60–64CrossRefPubMed Harvey AS, Freeman JL (2007) Epilepsy in hypothalamic hamartoma: clinical and EEG features. Semin Pediatr Neurol 14:60–64CrossRefPubMed
31.
Zurück zum Zitat Harvey AS, Freeman JL, Berkovic SF, Rosenfeld JV (2003) Transcallosal resection of hypothalamic hamartomas in patients with intractable epilepsy. Epileptic Disord 5:257–265PubMed Harvey AS, Freeman JL, Berkovic SF, Rosenfeld JV (2003) Transcallosal resection of hypothalamic hamartomas in patients with intractable epilepsy. Epileptic Disord 5:257–265PubMed
32.
Zurück zum Zitat Homma J, Kameyama S, Masuda H, Ueno T, Fujimoto A, Oishi M, Fukuda M (2007) Stereotactic radiofrequency thermocoagulation for hypothalamic hamartoma with intractable gelastic seizures. Epilepsy Res 76:15–21CrossRefPubMed Homma J, Kameyama S, Masuda H, Ueno T, Fujimoto A, Oishi M, Fukuda M (2007) Stereotactic radiofrequency thermocoagulation for hypothalamic hamartoma with intractable gelastic seizures. Epilepsy Res 76:15–21CrossRefPubMed
33.
Zurück zum Zitat Jung H, Neumaier Probst E, Hauffa BP, Partsch CJ, Dammann O (2003) Association of morphological characteristics with precocious puberty and/or gelastic seizures in hypothalamic hamartoma. J Clin Endocrinol Metab 88:4590–4595CrossRefPubMed Jung H, Neumaier Probst E, Hauffa BP, Partsch CJ, Dammann O (2003) Association of morphological characteristics with precocious puberty and/or gelastic seizures in hypothalamic hamartoma. J Clin Endocrinol Metab 88:4590–4595CrossRefPubMed
34.
Zurück zum Zitat Kahane P, Ryvlin P, Hoffmann D, Minotti L, Benabid AL (2003) From hypothalamic hamartoma to cortex: what can be learnt from depth recordings and stimulation? Epileptic Disord 5:205–217PubMed Kahane P, Ryvlin P, Hoffmann D, Minotti L, Benabid AL (2003) From hypothalamic hamartoma to cortex: what can be learnt from depth recordings and stimulation? Epileptic Disord 5:205–217PubMed
35.
Zurück zum Zitat Kerrigan JF, Ng YT, Chung S, Rekate HL (2005) The hypothalamic hamartoma: a model of subcortical epileptogenesis and encephalopathy. Semin Pediatr Neurol 12:119–131CrossRefPubMed Kerrigan JF, Ng YT, Chung S, Rekate HL (2005) The hypothalamic hamartoma: a model of subcortical epileptogenesis and encephalopathy. Semin Pediatr Neurol 12:119–131CrossRefPubMed
36.
Zurück zum Zitat Kramer U, Spector S, Nasser W, Siomin V, Fried I, Constantini S (2001) Surgical treatment of hypothalamic hamartoma and refractory seizures: a case report and review of the literature. Pediatr Neurosurg 34:40–42CrossRefPubMed Kramer U, Spector S, Nasser W, Siomin V, Fried I, Constantini S (2001) Surgical treatment of hypothalamic hamartoma and refractory seizures: a case report and review of the literature. Pediatr Neurosurg 34:40–42CrossRefPubMed
37.
Zurück zum Zitat Kuzniecky R, Guthrie B, Mountz J, Bebin M, Faught E, Gilliam F, Liu HG (1997) Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol 42:60–67CrossRefPubMed Kuzniecky R, Guthrie B, Mountz J, Bebin M, Faught E, Gilliam F, Liu HG (1997) Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol 42:60–67CrossRefPubMed
38.
Zurück zum Zitat Kuzniecky RI, Guthrie BL (2003) Stereotactic surgical approach to hypothalamic hamartomas. Epileptic Disord 5:275–280PubMed Kuzniecky RI, Guthrie BL (2003) Stereotactic surgical approach to hypothalamic hamartomas. Epileptic Disord 5:275–280PubMed
39.
Zurück zum Zitat Leal AJ, Moreira A, Robalo C, Ribeiro C (2003) Different electroclinical manifestations of the epilepsy associated with hamartomas connecting to the middle or posterior hypothalamus. Epilepsia 44:1191–1195CrossRefPubMed Leal AJ, Moreira A, Robalo C, Ribeiro C (2003) Different electroclinical manifestations of the epilepsy associated with hamartomas connecting to the middle or posterior hypothalamus. Epilepsia 44:1191–1195CrossRefPubMed
40.
Zurück zum Zitat Likavec AM, Dickerman RD, Heiss JD, Liow K (2000) Retrospective analysis of surgical treatment outcomes for gelastic seizures: a review of the literature. Seizure 9:204–207CrossRefPubMed Likavec AM, Dickerman RD, Heiss JD, Liow K (2000) Retrospective analysis of surgical treatment outcomes for gelastic seizures: a review of the literature. Seizure 9:204–207CrossRefPubMed
41.
Zurück zum Zitat Machado HR, Hoffman HJ, Hwang PA (1991) Gelastic seizures treated by resection of a hypothalamic hamartoma. Childs Nerv Syst 7:462–465CrossRefPubMed Machado HR, Hoffman HJ, Hwang PA (1991) Gelastic seizures treated by resection of a hypothalamic hamartoma. Childs Nerv Syst 7:462–465CrossRefPubMed
42.
Zurück zum Zitat Maixner W (2006) Hypothalamic hamartomas—clinical, neuropathological, and surgical aspects. Childs Nerv Syst 22:867–873CrossRefPubMed Maixner W (2006) Hypothalamic hamartomas—clinical, neuropathological, and surgical aspects. Childs Nerv Syst 22:867–873CrossRefPubMed
43.
Zurück zum Zitat Mathieu D, Kondziolka D, Niranjan A, Flickinger J, Lunsford LD (2006) Gamma knife radiosurgery for refractory epilepsy caused by hypothalamic hamartomas. Stereotact Funct Neurosurg 84:82–87CrossRefPubMed Mathieu D, Kondziolka D, Niranjan A, Flickinger J, Lunsford LD (2006) Gamma knife radiosurgery for refractory epilepsy caused by hypothalamic hamartomas. Stereotact Funct Neurosurg 84:82–87CrossRefPubMed
44.
Zurück zum Zitat Morrell F (1985) Secondary epileptogenesis in man. Arch Neurol 42:318–335PubMed Morrell F (1985) Secondary epileptogenesis in man. Arch Neurol 42:318–335PubMed
45.
Zurück zum Zitat Morrell F (1989) Varieties of human secondary epileptogenesis. J Clin Neurophysiol 6:227–275PubMedCrossRef Morrell F (1989) Varieties of human secondary epileptogenesis. J Clin Neurophysiol 6:227–275PubMedCrossRef
46.
Zurück zum Zitat Mottolese C, Stan H, Bret P, Berlier P, Lapras C (2001) Hypothalamic hamartoma: the role of surgery in a series of eight patients. Childs Nerv Syst 17:229–236, discussion 237-228CrossRefPubMed Mottolese C, Stan H, Bret P, Berlier P, Lapras C (2001) Hypothalamic hamartoma: the role of surgery in a series of eight patients. Childs Nerv Syst 17:229–236, discussion 237-228CrossRefPubMed
47.
Zurück zum Zitat Mullatti N (2003) Hypothalamic hamartoma in adults. Epileptic Disord 5:201–204PubMed Mullatti N (2003) Hypothalamic hamartoma in adults. Epileptic Disord 5:201–204PubMed
48.
Zurück zum Zitat Mullatti N, Selway R, Nashef L, Elwes R, Honavar M, Chandler C, Morris R, Jarosz J, Buchanan C, Polkey C (2003) The clinical spectrum of epilepsy in children and adults with hypothalamic hamartoma. Epilepsia 44:1310–1319CrossRefPubMed Mullatti N, Selway R, Nashef L, Elwes R, Honavar M, Chandler C, Morris R, Jarosz J, Buchanan C, Polkey C (2003) The clinical spectrum of epilepsy in children and adults with hypothalamic hamartoma. Epilepsia 44:1310–1319CrossRefPubMed
49.
Zurück zum Zitat Munari C, Kahane P, Francione S, Hoffmann D, Tassi L, Cusmai R, Vigevano F, Pasquier B, Betti OO (1995) Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol 95:154–160CrossRefPubMed Munari C, Kahane P, Francione S, Hoffmann D, Tassi L, Cusmai R, Vigevano F, Pasquier B, Betti OO (1995) Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol 95:154–160CrossRefPubMed
50.
Zurück zum Zitat Murphy JV, Wheless JW, Schmoll CM (2000) Left vagal nerve stimulation in six patients with hypothalamic hamartomas. Pediatr Neurol 23:167–168CrossRefPubMed Murphy JV, Wheless JW, Schmoll CM (2000) Left vagal nerve stimulation in six patients with hypothalamic hamartomas. Pediatr Neurol 23:167–168CrossRefPubMed
51.
Zurück zum Zitat Ng YT, Kerrigan JF, Prenger EC, White WL, Rekate HL (2005) Successful resection of a hypothalamic hamartoma and a Rathke cleft cyst. Case report. J Neurosurg 102:78–80PubMed Ng YT, Kerrigan JF, Prenger EC, White WL, Rekate HL (2005) Successful resection of a hypothalamic hamartoma and a Rathke cleft cyst. Case report. J Neurosurg 102:78–80PubMed
52.
Zurück zum Zitat Ng YT, Rekate HL (2007) Endoscopic resection of hypothalamic hamartoma for refractory epilepsy: preliminary report. Semin Pediatr Neurol 14:99–105CrossRefPubMed Ng YT, Rekate HL (2007) Endoscopic resection of hypothalamic hamartoma for refractory epilepsy: preliminary report. Semin Pediatr Neurol 14:99–105CrossRefPubMed
53.
Zurück zum Zitat Ng Y, Rekate H, Kerrigan J et al (2004) Transcallosal resection of hypothalamic hamartoma: case report. Barrow Quarterly 20:No 1 Ng Y, Rekate H, Kerrigan J et al (2004) Transcallosal resection of hypothalamic hamartoma: case report. Barrow Quarterly 20:No 1
54.
Zurück zum Zitat Ng YT, Rekate HL, Prenger EC, Chung SS, Feiz-Erfan I, Wang NC, Varland MR, Kerrigan JF (2006) Transcallosal resection of hypothalamic hamartoma for intractable epilepsy. Epilepsia 47:1192–1202CrossRefPubMed Ng YT, Rekate HL, Prenger EC, Chung SS, Feiz-Erfan I, Wang NC, Varland MR, Kerrigan JF (2006) Transcallosal resection of hypothalamic hamartoma for intractable epilepsy. Epilepsia 47:1192–1202CrossRefPubMed
55.
Zurück zum Zitat Ng YT, Rekate HL, Prenger EC, Wang NC, Chung SS, Feiz-Erfan I, Johnsonbaugh RE, Varland MR, Kerrigan JF (2008) Endoscopic resection of hypothalamic hamartomas for refractory symptomatic epilepsy. Neurology 70:1543–1548CrossRefPubMed Ng YT, Rekate HL, Prenger EC, Wang NC, Chung SS, Feiz-Erfan I, Johnsonbaugh RE, Varland MR, Kerrigan JF (2008) Endoscopic resection of hypothalamic hamartomas for refractory symptomatic epilepsy. Neurology 70:1543–1548CrossRefPubMed
56.
Zurück zum Zitat Nguyen D, Singh S, Zaatreh M, Novotny E, Levy S, Testa F, Spencer SS (2003) Hypothalamic hamartomas: seven cases and review of the literature. Epilepsy Behav 4:246–258CrossRefPubMed Nguyen D, Singh S, Zaatreh M, Novotny E, Levy S, Testa F, Spencer SS (2003) Hypothalamic hamartomas: seven cases and review of the literature. Epilepsy Behav 4:246–258CrossRefPubMed
57.
Zurück zum Zitat Nishio S, Morioka T, Fukui M, Goto Y (1994) Surgical treatment of intractable seizures due to hypothalamic hamartoma. Epilepsia 35:514–519CrossRefPubMed Nishio S, Morioka T, Fukui M, Goto Y (1994) Surgical treatment of intractable seizures due to hypothalamic hamartoma. Epilepsia 35:514–519CrossRefPubMed
58.
Zurück zum Zitat Northfield DW, Russell DS (1967) Pubertas praecox due to hypothalamic hamartoma: report of two cases surviving surgical removal of the tumour. J Neurol Neurosurg Psychiatry 30:166–173CrossRefPubMed Northfield DW, Russell DS (1967) Pubertas praecox due to hypothalamic hamartoma: report of two cases surviving surgical removal of the tumour. J Neurol Neurosurg Psychiatry 30:166–173CrossRefPubMed
59.
Zurück zum Zitat Paillas JE, Roger J, Toga M, Soulayrol R, Salamon G, Dravet C, Bureau M (1969) Hamartoma of the hypothalamus. Clinical, radiological and histological study. Results of excision. Rev Neurol (Paris) 120:177–194 Paillas JE, Roger J, Toga M, Soulayrol R, Salamon G, Dravet C, Bureau M (1969) Hamartoma of the hypothalamus. Clinical, radiological and histological study. Results of excision. Rev Neurol (Paris) 120:177–194
60.
Zurück zum Zitat Palmini A, Chandler C, Andermann F, Costa Da Costa J, Paglioli-Neto E, Polkey C, Rosenblatt B, Montes J, Martinez JV, Farmer JP, Sinclair B, Aronyk K, Paglioli E, Coutinho L, Raupp S, Portuguez M (2002) Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology 58:1338–1347PubMed Palmini A, Chandler C, Andermann F, Costa Da Costa J, Paglioli-Neto E, Polkey C, Rosenblatt B, Montes J, Martinez JV, Farmer JP, Sinclair B, Aronyk K, Paglioli E, Coutinho L, Raupp S, Portuguez M (2002) Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology 58:1338–1347PubMed
61.
Zurück zum Zitat Palmini A, Paglioli-Neto E, Montes J, Farmer JP (2003) The treatment of patients with hypothalamic hamartomas, epilepsy and behavioural abnormalities: facts and hypotheses. Epileptic Disord 5:249–255PubMed Palmini A, Paglioli-Neto E, Montes J, Farmer JP (2003) The treatment of patients with hypothalamic hamartomas, epilepsy and behavioural abnormalities: facts and hypotheses. Epileptic Disord 5:249–255PubMed
62.
Zurück zum Zitat Palmini A, Van Paesschen W, Dupont P, Van Laere K, Van Driel G (2005) Status gelasticus after temporal lobectomy: ictal FDG-PET findings and the question of dual pathology involving hypothalamic hamartomas. Epilepsia 46:1313–1316CrossRefPubMed Palmini A, Van Paesschen W, Dupont P, Van Laere K, Van Driel G (2005) Status gelasticus after temporal lobectomy: ictal FDG-PET findings and the question of dual pathology involving hypothalamic hamartomas. Epilepsia 46:1313–1316CrossRefPubMed
63.
Zurück zum Zitat Papez JW (1995) A proposed mechanism of emotion. 1937. J Neuropsychiatry Clin Neurosci 7:103–112PubMed Papez JW (1995) A proposed mechanism of emotion. 1937. J Neuropsychiatry Clin Neurosci 7:103–112PubMed
64.
Zurück zum Zitat Parrent AG (1999) Stereotactic radiofrequency ablation for the treatment of gelastic seizures associated with hypothalamic hamartoma. Case report. J Neurosurg 91:881–884CrossRefPubMed Parrent AG (1999) Stereotactic radiofrequency ablation for the treatment of gelastic seizures associated with hypothalamic hamartoma. Case report. J Neurosurg 91:881–884CrossRefPubMed
65.
Zurück zum Zitat Penfold JL, Manson JI, Caldicott WM (1978) Laughing seizures and precocious puberty (case report and review of the literature). Aust Paediatr J 14:185–190PubMed Penfold JL, Manson JI, Caldicott WM (1978) Laughing seizures and precocious puberty (case report and review of the literature). Aust Paediatr J 14:185–190PubMed
66.
Zurück zum Zitat Prigatano GP (2007) Cognitive and behavioral dysfunction in children with hypothalamic hamartoma and epilepsy. Semin Pediatr Neurol 14:65–72CrossRefPubMed Prigatano GP (2007) Cognitive and behavioral dysfunction in children with hypothalamic hamartoma and epilepsy. Semin Pediatr Neurol 14:65–72CrossRefPubMed
67.
Zurück zum Zitat Procaccini E, Dorfmuller G, Fohlen M, Bulteau C, Delalande O (2006) Surgical management of hypothalamic hamartomas with epilepsy: the stereoendoscopic approach. Neurosurgery 59:ONS336–ONS344, discussion ONS344-336CrossRefPubMed Procaccini E, Dorfmuller G, Fohlen M, Bulteau C, Delalande O (2006) Surgical management of hypothalamic hamartomas with epilepsy: the stereoendoscopic approach. Neurosurgery 59:ONS336–ONS344, discussion ONS344-336CrossRefPubMed
68.
Zurück zum Zitat Quigg M, Barbaro NM (2008) Stereotactic radiosurgery for treatment of epilepsy. Arch Neurol 65:177–183CrossRefPubMed Quigg M, Barbaro NM (2008) Stereotactic radiosurgery for treatment of epilepsy. Arch Neurol 65:177–183CrossRefPubMed
69.
Zurück zum Zitat Regis J, Bartolomei F, de Toffol B, Genton P, Kobayashi T, Mori Y, Takakura K, Hori T, Inoue H, Schrottner O, Pendl G, Wolf A, Arita K, Chauvel P (2000) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Neurosurgery 47:1343–1351, discussion 1351-1342CrossRefPubMed Regis J, Bartolomei F, de Toffol B, Genton P, Kobayashi T, Mori Y, Takakura K, Hori T, Inoue H, Schrottner O, Pendl G, Wolf A, Arita K, Chauvel P (2000) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Neurosurgery 47:1343–1351, discussion 1351-1342CrossRefPubMed
70.
Zurück zum Zitat Regis J, Bartolomei F, Hayashi M, Roberts D, Chauvel P, Peragut JC (2000) The role of gamma knife surgery in the treatment of severe epilepsies. Epileptic Disord 2:113–122PubMed Regis J, Bartolomei F, Hayashi M, Roberts D, Chauvel P, Peragut JC (2000) The role of gamma knife surgery in the treatment of severe epilepsies. Epileptic Disord 2:113–122PubMed
71.
Zurück zum Zitat Regis J, Bartolomei F, Rey M, Hayashi M, Porcheron D, Chauvel P, Peragut JC (2002) Gamma knife radiosurgery for the treatment of severe epilepsy. Rev Neurol (Paris) 158:405–411 Regis J, Bartolomei F, Rey M, Hayashi M, Porcheron D, Chauvel P, Peragut JC (2002) Gamma knife radiosurgery for the treatment of severe epilepsy. Rev Neurol (Paris) 158:405–411
72.
Zurück zum Zitat Regis J, Hayashi M, Eupierre LP, Villeneuve N, Bartolomei F, Brue T, Chauvel P (2004) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Acta Neurochir Suppl 91:33–50PubMed Regis J, Hayashi M, Eupierre LP, Villeneuve N, Bartolomei F, Brue T, Chauvel P (2004) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Acta Neurochir Suppl 91:33–50PubMed
73.
Zurück zum Zitat Regis J, Scavarda D, Tamura M, Villeneuve N, Bartolomei F, Brue T, Morange I, Dafonseca D, Chauvel P (2007) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Semin Pediatr Neurol 14:73–79CrossRefPubMed Regis J, Scavarda D, Tamura M, Villeneuve N, Bartolomei F, Brue T, Morange I, Dafonseca D, Chauvel P (2007) Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Semin Pediatr Neurol 14:73–79CrossRefPubMed
74.
Zurück zum Zitat Rekate HL, Feiz-Erfan I, Ng YT, Gonzalez LF, Kerrigan JF (2006) Endoscopic surgery for hypothalamic hamartomas causing medically refractory gelastic epilepsy. Childs Nerv Syst 22:874–880CrossRefPubMed Rekate HL, Feiz-Erfan I, Ng YT, Gonzalez LF, Kerrigan JF (2006) Endoscopic surgery for hypothalamic hamartomas causing medically refractory gelastic epilepsy. Childs Nerv Syst 22:874–880CrossRefPubMed
75.
Zurück zum Zitat Rosenfeld JV, Harvey AS, Wrennall J, Zacharin M, Berkovic SF (2001) Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy. Neurosurgery 48:108–118CrossRefPubMed Rosenfeld JV, Harvey AS, Wrennall J, Zacharin M, Berkovic SF (2001) Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy. Neurosurgery 48:108–118CrossRefPubMed
76.
Zurück zum Zitat Ryvlin P, Ravier C, Bouvard S, Mauguire F, Le Bars D, Arzimanoglou A, Petit J, Kahane P (2003) Positron emission tomography in epileptogenic hypothalamic hamartomas. Epileptic Disord 5:219–227PubMed Ryvlin P, Ravier C, Bouvard S, Mauguire F, Le Bars D, Arzimanoglou A, Petit J, Kahane P (2003) Positron emission tomography in epileptogenic hypothalamic hamartomas. Epileptic Disord 5:219–227PubMed
77.
Zurück zum Zitat Sato M, Ushio Y, Arita N, Mogami H (1985) Hypothalamic hamartoma: report of two cases. Neurosurgery 16:198–206CrossRefPubMed Sato M, Ushio Y, Arita N, Mogami H (1985) Hypothalamic hamartoma: report of two cases. Neurosurgery 16:198–206CrossRefPubMed
78.
Zurück zum Zitat Savard G, Bhanji NH, Dubeau F, Andermann F, Sadikot A (2003) Psychiatric aspects of patients with hypothalamic hamartoma and epilepsy. Epileptic Disord 5:229–234PubMed Savard G, Bhanji NH, Dubeau F, Andermann F, Sadikot A (2003) Psychiatric aspects of patients with hypothalamic hamartoma and epilepsy. Epileptic Disord 5:229–234PubMed
79.
Zurück zum Zitat Schulze-Bonhage A, Homberg V, Trippel M, Keimer R, Elger CE, Warnke PC, Ostertag C (2004) Interstitial radiosurgery in the treatment of gelastic epilepsy due to hypothalamic hamartomas. Neurology 62:644–647PubMed Schulze-Bonhage A, Homberg V, Trippel M, Keimer R, Elger CE, Warnke PC, Ostertag C (2004) Interstitial radiosurgery in the treatment of gelastic epilepsy due to hypothalamic hamartomas. Neurology 62:644–647PubMed
80.
Zurück zum Zitat Schulze-Bonhage A, Ostertag C (2007) Treatment options for gelastic epilepsy due to hypothalamic hamartoma: interstitial radiosurgery. Semin Pediatr Neurol 14:80–87CrossRefPubMed Schulze-Bonhage A, Ostertag C (2007) Treatment options for gelastic epilepsy due to hypothalamic hamartoma: interstitial radiosurgery. Semin Pediatr Neurol 14:80–87CrossRefPubMed
81.
Zurück zum Zitat Schulze-Bonhage A, Trippel M, Wagner K, Bast T, Deimling FV, Ebner A, Elger C, Mayer T, Keimer R, Steinhoff BJ, Spreer J, Fauser S, Ostertag C (2008) Outcome and predictors of interstitial radiosurgery in the treatment of gelastic epilepsy. Neurology 71:277–282CrossRefPubMed Schulze-Bonhage A, Trippel M, Wagner K, Bast T, Deimling FV, Ebner A, Elger C, Mayer T, Keimer R, Steinhoff BJ, Spreer J, Fauser S, Ostertag C (2008) Outcome and predictors of interstitial radiosurgery in the treatment of gelastic epilepsy. Neurology 71:277–282CrossRefPubMed
82.
Zurück zum Zitat Selch MT, Gorgulho A, Mattozo C, Solberg TD, Cabatan-Awang C, DeSalles AA (2005) Linear accelerator stereotactic radiosurgery for the treatment of gelastic seizures due to hypothalamic hamartoma. Minim Invasive Neurosurg 48:310–314CrossRefPubMed Selch MT, Gorgulho A, Mattozo C, Solberg TD, Cabatan-Awang C, DeSalles AA (2005) Linear accelerator stereotactic radiosurgery for the treatment of gelastic seizures due to hypothalamic hamartoma. Minim Invasive Neurosurg 48:310–314CrossRefPubMed
83.
Zurück zum Zitat Sher PK, Brown SB (1976) Gelastic epilepsy. Onset in neonatal period. Am J Dis Child 130:1126–1131PubMed Sher PK, Brown SB (1976) Gelastic epilepsy. Onset in neonatal period. Am J Dis Child 130:1126–1131PubMed
84.
Zurück zum Zitat Shim KW, Chang JH, Park YG, Kim HD, Choi JU, Kim DS (2008) Treatment modality for intractable epilepsy in hypothalamic hamartomatous lesions. Neurosurgery 62:847–856, discussion 856CrossRefPubMed Shim KW, Chang JH, Park YG, Kim HD, Choi JU, Kim DS (2008) Treatment modality for intractable epilepsy in hypothalamic hamartomatous lesions. Neurosurgery 62:847–856, discussion 856CrossRefPubMed
85.
Zurück zum Zitat Siomin V, Spektor S, Beni-Adani L, Constantini S (2001) Application of the orbito-cranial approach in pediatric neurosurgery. Childs Nerv Syst 17:612–617CrossRefPubMed Siomin V, Spektor S, Beni-Adani L, Constantini S (2001) Application of the orbito-cranial approach in pediatric neurosurgery. Childs Nerv Syst 17:612–617CrossRefPubMed
86.
Zurück zum Zitat Siwanuwatn R, Deshmukh P, Feiz-Erfan I, Rekate HL, Zabramski JM, Spetzler RF, Rosenfeld JV (2005) Microsurgical anatomy of the transcallosal anterior interforniceal approach to the third ventricle. Neurosurgery 56:390–396, discussion 390–396CrossRefPubMed Siwanuwatn R, Deshmukh P, Feiz-Erfan I, Rekate HL, Zabramski JM, Spetzler RF, Rosenfeld JV (2005) Microsurgical anatomy of the transcallosal anterior interforniceal approach to the third ventricle. Neurosurgery 56:390–396, discussion 390–396CrossRefPubMed
87.
Zurück zum Zitat Striano S, Meo R, Bilo L, Cirillo S, Nocerino C, Ruosi P, Striano P, Estraneo A (1999) Gelastic epilepsy: symptomatic and cryptogenic cases. Epilepsia 40:294–302CrossRefPubMed Striano S, Meo R, Bilo L, Cirillo S, Nocerino C, Ruosi P, Striano P, Estraneo A (1999) Gelastic epilepsy: symptomatic and cryptogenic cases. Epilepsia 40:294–302CrossRefPubMed
88.
Zurück zum Zitat Sturm JW, Andermann F, Berkovic SF (2000) “Pressure to laugh”: an unusual epileptic symptom associated with small hypothalamic hamartomas. Neurology 54:971–973PubMed Sturm JW, Andermann F, Berkovic SF (2000) “Pressure to laugh”: an unusual epileptic symptom associated with small hypothalamic hamartomas. Neurology 54:971–973PubMed
89.
Zurück zum Zitat Tassinari CA, Riguzzi P, Rizzi R et al (1997) Gelastic seizures. In: Tuxhorn I, Hothausen H, Boenigk H (eds) Paediatric epilepsy syndromes and their surgical treatment. John Libbey, London, pp 429–446 Tassinari CA, Riguzzi P, Rizzi R et al (1997) Gelastic seizures. In: Tuxhorn I, Hothausen H, Boenigk H (eds) Paediatric epilepsy syndromes and their surgical treatment. John Libbey, London, pp 429–446
90.
Zurück zum Zitat Unger F, Schrottner O, Feichtinger M, Bone G, Haselsberger K, Sutter B (2002) Stereotactic radiosurgery for hypothalamic hamartomas. Acta Neurochir Suppl 84:57–63PubMed Unger F, Schrottner O, Feichtinger M, Bone G, Haselsberger K, Sutter B (2002) Stereotactic radiosurgery for hypothalamic hamartomas. Acta Neurochir Suppl 84:57–63PubMed
91.
Zurück zum Zitat Valdueza JM, Cristante L, Dammann O, Bentele K, Vortmeyer A, Saeger W, Padberg B, Freitag J, Herrmann HD (1994) Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery 34:949–958, discussion 958CrossRefPubMed Valdueza JM, Cristante L, Dammann O, Bentele K, Vortmeyer A, Saeger W, Padberg B, Freitag J, Herrmann HD (1994) Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery 34:949–958, discussion 958CrossRefPubMed
92.
Zurück zum Zitat Weissenberger AA, Dell ML, Liow K, Theodore W, Frattali CM, Hernandez D, Zametkin AJ (2001) Aggression and psychiatric comorbidity in children with hypothalamic hamartomas and their unaffected siblings. J Am Acad Child Adolesc Psychiatry 40:696–703CrossRefPubMed Weissenberger AA, Dell ML, Liow K, Theodore W, Frattali CM, Hernandez D, Zametkin AJ (2001) Aggression and psychiatric comorbidity in children with hypothalamic hamartomas and their unaffected siblings. J Am Acad Child Adolesc Psychiatry 40:696–703CrossRefPubMed
93.
Zurück zum Zitat Wu J, Xu L, Kim DY, Rho JM, St John PA, Lue LF, Coons S, Ellsworth K, Nowak L, Johnson E, Rekate H, Kerrigan JF (2005) Electrophysiological properties of human hypothalamic hamartomas. Ann Neurol 58:371–382CrossRefPubMed Wu J, Xu L, Kim DY, Rho JM, St John PA, Lue LF, Coons S, Ellsworth K, Nowak L, Johnson E, Rekate H, Kerrigan JF (2005) Electrophysiological properties of human hypothalamic hamartomas. Ann Neurol 58:371–382CrossRefPubMed
Metadaten
Titel
A review on the management of epilepsy associated with hypothalamic hamartomas
verfasst von
James L. Frazier
C. Rory Goodwin
Edward S. Ahn
George I. Jallo
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 4/2009
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-008-0798-y

Weitere Artikel der Ausgabe 4/2009

Child's Nervous System 4/2009 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.