In situ single-unit recording of hypothalamic hamartomas under endoscopic direct visualization

Neurosurgery
Gregory P LekovicPeter N Steinmetz

Abstract

Hypothalamic hamartomas (HHs) are associated with refractory epilepsy and are amenable to surgical treatment. The gelastic seizures associated with HHs originate within the HH lesion, but the responsible cellular mechanisms are unknown. Microelectrode patch-clamp recordings from HH neurons in resected slice preparations show that small HH neurons spontaneously fire with intrinsic pacemaker-like activity. We questioned whether spontaneous firing of HH neurons was present in situ, and we hypothesized that single-unit field recordings from HH tissue could be obtained with instrumentation passed through the endoscope before surgical resection. After informed consent was obtained, patients undergoing transventricular, endoscopic resection of an HH for intractable epilepsy were eligible for study. After placement of the endoscope, a bundled microwire (total of 9 contacts) was placed into the HH under direct visualization. Spontaneous activity was recorded for two or three 5-minute epochs, under steady-state general anesthesia. The wire was advanced 0.5 to 1 mm within the lesion between recording epochs. A total of thirteen 5-minute recordings were obtained from 5 patients. Noise levels were comparable to extraoperative microwire reco...Continue Reading

References

Sep 1, 1995·Electroencephalography and Clinical Neurophysiology·C MunariO O Betti
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Sep 1, 2004·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jeffrey V RosenfeldA Simon Harvey
Aug 24, 2005·Seminars in Pediatric Neurology·John F KerriganHarold L Rekate
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Jun 30, 2006·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jean RégisPatrick Chauvel
Oct 4, 2006·Journal of Cognitive Neuroscience·Indre V ViskontasItzhak Fried
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Feb 7, 2008·American Journal of Human Genetics·David W CraigJohn F Kerrigan
Feb 20, 2009·IEEE Transactions on Bio-medical Engineering·Christopher K Thorp, Peter N Steinmetz

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