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Invasive EEG in Hypothalamic Hamartoma 

Invasive EEG in Hypothalamic Hamartoma
Invasive EEG in Hypothalamic Hamartoma

Julia Scholly

, Fabrice Bartolomei

, and Edouard Hirsch

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date: 12 July 2020

This chapter reviews pathophysiological aspects of the epilepsy syndrome associated with hypothalamic hamartoma (HH), including the concept of secondary epileptogenesis, as well as indications, limits, and practical issues of intracranial EEG exploration and interpretation in this setting. It focuses on particularities of interictal and ictal intracerebral stereotactic EEG (SEEG) findings and demonstrates different patterns of SEEG seizure initiation, in both gelastic and other seizure types. It describes two challenging clinical cases supported by diagrams and original SEEG traces that illustrate complex relationships among the HH, the limbic system, and the neocortex arguing for network organization of the epileptogenic zone in HH-associated pharmacoresistant epilepsy. It also reviews surgical strategies and postsurgical prognosis after SEEG exploration and discusses SEEG-guided minimally invasive therapeutic options aiming at HH. It is written for both trainees and more experienced neurologists, neurophysiologists and neurosurgeons in continuing professional development.

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