Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method
Besides gelastic seizures, hypothalamic hamartoma (HH) is also noted for its susceptibility to remote secondary epileptogenesis. Although clinical observations have demonstrated its existence, and a three-stage theory has been proposed, how to determine whether a remote symptom is spontaneous or dep...
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Frontiers Media S.A.
2020-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00478/full |
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| author | Zhao Liu Zhao Liu Guoming Luan Guoming Luan Guoming Luan Chuanzuo Yang Yuguang Guan Changqing Liu Jing Wang Mengyang Wang Qingyun Wang |
| author_facet | Zhao Liu Zhao Liu Guoming Luan Guoming Luan Guoming Luan Chuanzuo Yang Yuguang Guan Changqing Liu Jing Wang Mengyang Wang Qingyun Wang |
| author_sort | Zhao Liu |
| collection | DOAJ |
| description | Besides gelastic seizures, hypothalamic hamartoma (HH) is also noted for its susceptibility to remote secondary epileptogenesis. Although clinical observations have demonstrated its existence, and a three-stage theory has been proposed, how to determine whether a remote symptom is spontaneous or dependent on epileptic activities of HH is difficult in some cases. Herein, we report a case of new non-gelastic seizures in a 9-year-old female associated with a postoperatively remaining HH. Electrophysiological examinations and stereo-electroencephalography (SEEG) demonstrated seizure onsets with slow-wave and fast activities on the outside of the HH. By using computational methodologies to calculate the network dynamic effective connectivities, the importance of HH in the epileptic network was revealed. After SEEG-guided thermal coagulation of the remaining HH, the patient finally was seizure-free at the 2-year follow-up. This case showed the ability of computational methods to reveal information underlying complex SEEG signals, and further demonstrated the dependent-stage secondary epileptogenesis, which has been rarely reported. |
| first_indexed | 2024-12-19T19:10:53Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T19:10:53Z |
| publishDate | 2020-06-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-fac5fd6515cd418383954ce49d04c8f02022-12-21T20:09:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-06-011110.3389/fneur.2020.00478523479Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational MethodZhao Liu0Zhao Liu1Guoming Luan2Guoming Luan3Guoming Luan4Chuanzuo Yang5Yuguang Guan6Changqing Liu7Jing Wang8Mengyang Wang9Qingyun Wang10Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy, Epilepsy Center, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy, Epilepsy Center, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Institute for Brain Disorders, Beijing, ChinaDepartment of Dynamics and Control, Beihang University, Beijing, ChinaDepartment of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Dynamics and Control, Beihang University, Beijing, ChinaBesides gelastic seizures, hypothalamic hamartoma (HH) is also noted for its susceptibility to remote secondary epileptogenesis. Although clinical observations have demonstrated its existence, and a three-stage theory has been proposed, how to determine whether a remote symptom is spontaneous or dependent on epileptic activities of HH is difficult in some cases. Herein, we report a case of new non-gelastic seizures in a 9-year-old female associated with a postoperatively remaining HH. Electrophysiological examinations and stereo-electroencephalography (SEEG) demonstrated seizure onsets with slow-wave and fast activities on the outside of the HH. By using computational methodologies to calculate the network dynamic effective connectivities, the importance of HH in the epileptic network was revealed. After SEEG-guided thermal coagulation of the remaining HH, the patient finally was seizure-free at the 2-year follow-up. This case showed the ability of computational methods to reveal information underlying complex SEEG signals, and further demonstrated the dependent-stage secondary epileptogenesis, which has been rarely reported.https://www.frontiersin.org/article/10.3389/fneur.2020.00478/fullstereo-electroencephalographyrefractory focal epilepsyepileptogenic zone localizationcoupled neuronal population modelepileptogenic networkshypothalamic hamartoma |
| spellingShingle | Zhao Liu Zhao Liu Guoming Luan Guoming Luan Guoming Luan Chuanzuo Yang Yuguang Guan Changqing Liu Jing Wang Mengyang Wang Qingyun Wang Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method Frontiers in Neurology stereo-electroencephalography refractory focal epilepsy epileptogenic zone localization coupled neuronal population model epileptogenic networks hypothalamic hamartoma |
| title | Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method |
| title_full | Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method |
| title_fullStr | Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method |
| title_full_unstemmed | Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method |
| title_short | Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method |
| title_sort | distinguishing dependent stage secondary epileptogenesis in a complex case of giant hypothalamic hamartoma with assistance of a computational method |
| topic | stereo-electroencephalography refractory focal epilepsy epileptogenic zone localization coupled neuronal population model epileptogenic networks hypothalamic hamartoma |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00478/full |
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