Objective To analyze electroencephalogram(EEG)characteristics of hypothalamic hamartoma(HH)patients with gelastic seizures(GS)as initial symptom and prognosis.Methods TMedical records of 5 HH patients with GS as a primary form of seizures were collected from Kun-ming Sanbo Brain Hospital from May 2014 to October 2021.The characteristics of video EGG(VEEG)and stereo-EGG(SEEG)were analyzed.Therapeutic efficacy of SEEG-guided radiofrequen-cy thermocoagulation therapy was evaluated.Results Among the 5 patients with HH,there were 2 males and 3 females.During the interval,VEEG showed that 4 cases were normal,and 1 case had spike-and-slow complex wave discharge in the frontal and temporal regions.During the seizures,VEEG showed that all 5 cases exhibited mode a:diffuse potential reduction and low-voltage fast(LVF).During intermittent episodes,SEEG showed spike-slow wave complex and multi-spike-wave discharges in all 5 cases.In episodic episodes,there were 3 cases with mode 1-LVF combined with rhythmic spike discharge and 2 cases with mode 2-low potential reduced to periodic spike-slow dis-charge,suggesting that mode 1 was associated with good prognosis.The mean follow-up was at least 24 months after SEEG radiofrequency thermocoagulation.There were Engel grade Ⅰ 3 cases,Engel grade Ⅱ 1 case w and Engel grade Ⅲ 1 case.Among them,one case had recent complications and one case had late complications.Conclusion There are difficulties in locating VEEG in HH patients with GS as the initial symptom,while SEEG can record and reveal the origin of epileptic seizures.Addition-ally,HH patients can undergo minimally invasive radiofrequency ablation surgery guided by SEEG.SEEG-recorded low voltage fast combined rhythmic spike waves during the seizures may be an impor-tant indicator for predicting surgical efficacy.
维普
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