Role of Neurology in Barrow's Treatment of Hypothalamic Hamartoma
In some hypothalamic hamartoma (HH) cases, anticonvulsant medication may help to alleviate some occurrences of epileptic seizures. However, more commonly there is little or no help in controlling the frequency or duration of seizures associated with hypothalamic hamartoma. As a result, most children with this condition suffer multiple gelastic seizures daily.
The frequency of these seizures and the subsequent disruption to the brain often makes deterioration of the child's mental state unavoidable. Regression in the level of intellect sometimes leads to mental retardation and the rages and other behavioral problems may become very disabling.
|Drs. John Kerrigan and Yu-tze Ng
Barrow's Hypothalamic Hamartoma Team
The Barrow Division of Pediatric Neurology and Division of Neurology have several epileptologists who are dedicated members of the Barrow Hypothalamic Hamartoma Program.
Pediatric epilepsy specialists include John F. Kerrigan, M.D. (Co-Director of the Barrow Hypothalamic Hamartoma Program), Yu-tze Ng, M.D., Kevin Chapman, M.D., and Matthew Troester, D.O.
Our specialists are trained in all of the latest epilepsy treatments including pre-surgical evaluations, vagal nerve stimulator management, and ketogenic diet and have cared for many patients from all over the country with refractory seizures and hypothalamic hamartomas.
Our Approach to Hypothalamic Hamartoma Treatment
All hypothalamic hamartoma patients prior to surgery will be reviewed by one of the epileptologists to obtain a detailed seizure and antiepileptic drug (AED) history and detailed examination. This pre-operative baseline is very important to establish the postoperative comparison of surgical outcome and aid in directing ongoing therapies. Blood tests, AED levels, and other investigations will be performed, if needed. If the patient has a vagal nerve stimulator (VNS), this will be turned off prior to pre-operative MRI and operation.
In all cases, the patients' records will have been reviewed by one of the epileptologists well before the initial consultation and at times specific directions will be given (and discussed with their primary neurologists and caregivers) prior to the initial consultation. For example, this may include stopping valproic acid (Depakote or Depakene) about one week prior to the operation date. Post-operatively, a member of the pediatric neurology team will follow the patient and monitor AED treatment.
Our neurology team works very closely with the Department of Neurosurgery but particularly so within the Hypothalamic Hamartoma Program. We are striving to build a leading "Center of Excellence" for hypothalamic hamartoma evaluation, treatment, and research. Our efforts include clinical research regarding the best management of patients, such as seizures and behavior, and basic research questions touching on the neurobiology of this condition.
Read more about Hypothalamic Hamartoma research at Barrow > Hypothalamic Hamartoma Research