Advanced radiosurgery treats patient with decade-long seizures

Doctors of Apollo Cancer Centre performed advanced radiosurgery on a 23-year-old student who had been suffering from seizures for a decade.

Despite multiple antiepileptic medications, the seizures remained unpredictable and resistant to treatment. Sometimes the seizures arrived as sudden bursts of inappropriate laughter or blank stares.

Using advanced neuroimaging, doctors found a hypothalamic hamartoma, a rare benign lesion deep in the left hypothalamus and extending into the third ventricle (Type 3 lesion). It was located among the brain’s most vital passageways, including memory circuits, optic pathways, and endocrine control centres. Traditional surgery risks disturbing structures that cannot be disturbed, according to a press release.

At the Apollo Cancer Centre, a multidisciplinary team reviewed various options including open resection, endoscopic disconnection, laser ablation, and stereotactic radiosurgery. Radiosurgery required no incisions, caused no brain retraction, and avoided the risks of disconnecting delicate limbic pathways.

Based on the anatomical complexity and the patient’s decade-long symptoms, the team recommended fractionated stereotactic radiosurgery. He received ‘Cyberknife’ Radiosurgery, which was planned to sculpt the dose around critical structures while targeting the hamartoma.

Shankar Vangipuram, Senior Consultant, Division of Radiosurgery, said ‘CyberKnife’ radiosurgery provides sub-millimeter accuracy without the morbidity associated with open or endoscopic surgery. Follow-up assessments confirmed a stable recovery. He was seizure-free within four weeks, and had no acute side effects, the release said.