MRgFUS procedure for hypothalamic hamartoma
The operation for hypothalamic hamartoma that was performed
in Bashkortostan, previously only done in the USA
At the V.S. Buzaev International Medical Centre in Ufa, a clinical study has begun: the first patient had a tumor near the hypothalamus removed using ultrasound. This is the very center of the skull, where surgery is very difficult, and ultrasound allows for non-contact procedures.
Condition before surgery:
32 года
Ill since age 4 (gelastic seizures), at age 16 dacrystic and bilateral tonic-clonic seizures developed.
At the time of consultation in April 2022, a 32-year-old patient with a hypothalamic hamartoma three types of seizures were registered despite taking oxcarbazepine (1200 mg/day) and levetiracetam (500 mg/day):
1)isolated gelastic and dacrystic with preserved consciousness (up to 5-6 times a day);
2)focal hypomotor seizures with loss of consciousness, accompanied by gelastic
with dacryocystic manifestations, oral-alimentary automatisms, bimanual automatisms,
speech perseverations; (up to 2-4 times a month)
3)focal with evolution into bilateral tonic-clonic (once every 2 months)
Despite ongoing medication therapy, the frequency of seizures remained high: gelastic – up to 5-6 times a day, focal hypomotor – 2-4 times a month, bilateral tonic-clonic –
once every 2 months
MRgFUS perifocal ablation of hypothalamic hamartoma was performed.
Control video-EEG monitoring with 2-hour sleep deprivation was performed 6 months after MRgFUS dissection of the GPi: during sleep and wakefulness, regional epileptiform activity was recorded in the right temporal region in the form of single sharp-slow wave complexes, with a low representation index. Compared to the video EEG before the surgery, there is a clear positive dynamic in the form of a significant decrease in the representation index of epileptiform activity in the right hemisphere of the brain.
Since the dissection of the HH using MRgFUS, the patient has not experienced gelastic and dacrystic seizures for 6 months.
The frequency of tonic-clonic seizures, according to the seizure diary and the patient’s account, has decreased to once a month. The epileptologist is conducting dynamic monitoring of the patient. The patient continues taking medications without changes.
Overall, she notes obvious positive changes in daily life,
social and professional activities: confidently leads meetings at work, actively communicates with relatives and friends,
decided to quit smoking
For inquiries regarding planning MRgFUS for hypothalamic hamartoma, please contact
by phone +7 967 740-60-99 Neurosurgeon, Doctor of Medical Sciences, Rezida Maratovna Galimova
