International Consensus on the Evaluation and Management of Hypothalamic Hamartomas
This Delphi process highlights an international consensus on aspects of HH management. Gelastic/dacrystic seizures are important at diagnosis. A 3T epilepsy protocol MRI is essential. Early epilepsy surgery evaluation is advised. Surgery should be pursued either by disconnective, ablative, or resective techniques. HH location, size, and surgical experience are essential for good outcomes. Postoperative MRI should be obtained 6-12 months and/or if ongoing seizures. Neuropsychological testing should be obtained at baseline, and 6-12 months postsurgically. Findings support a multidisciplinary, protocol-driven approach to optimize outcomes in patients with HH. Areas lacking consensus, such as specific endocrine testing and timing of certain interventions, warrant further research and standardization.
Authors
- John Ragheb (ORCID: https://orcid.org/0000-0001-9480-6723)
- Cristine Mella Cukiert
- Erica Webster
- Arthur Cukiert (ORCID: https://orcid.org/0000-0002-6563-4149)
- John Kerrigan (ORCID: https://orcid.org/0000-0002-4867-0578)
- William D. Gaillard (ORCID: https://orcid.org/0000-0001-5709-0033)
- Daniel J. Curry (ORCID: https://orcid.org/0000-0003-3661-2976)
- Irfan Ali (ORCID: https://orcid.org/0000-0003-1760-1788)
- Margaret Zacharin (ORCID: https://orcid.org/0000-0001-5562-6818)
- J. Regis
- Hanna Richardson (ORCID: https://orcid.org/0009-0005-5589-8027)
- Angus A. Wilfong (ORCID: https://orcid.org/0000-0002-7755-7830)
- Wirginia Maixner (ORCID: https://orcid.org/0000-0002-9056-8278)
- Christine Bulteau
- Nathan T. Cohen (ORCID: https://orcid.org/0000-0002-1410-3487)
- Xinwei Li (ORCID: https://orcid.org/0000-0003-0555-2624)
- Sarah Ferrand-Sorbets
- Julia Jacobs
- M. Berl
- Kerstin Klotz
- Chima O. Oluigbo
- Lisa Soeby
- Dennis J. Dlugos
- Samuel F. Berkovic
- J. Helen Cross
- Kevin C.J. Yuen
- Martin M. Tisdall
- Elizabeth J. Donner
- Andreas Schulze-Bonhage
- Nicola Specchio
- Hiroshi Shirozu
- Phillip L. Pearl
- Alexis A. Arzimanoglou
Institutions
- Boston Children's Hospital (US)
- Royal Children's Hospital (AU)
- Barrow Neurological Institute (US)
- Children's Hospital of Philadelphia (US)
- Children's National (US)
- Harvard University (US)
- University of Calgary (CA)
- Baylor College of Medicine (US)
- University of Toronto (CA)
- George Washington University (US)
- University Hospital Bonn (DE)
- Great Ormond Street Hospital (GB)
- Hospital for Sick Children (CA)
- Alberta Children's Hospital (CA)
- Epilepsy Research UK (GB)
- Hospices Civils de Lyon (FR)
- Institut de Neurosciences des Systèmes (FR)
- Bambino Gesù Children's Hospital (IT)
- Hospital San Juan de Dios (CL)
- Fondation de Rothschild (FR)
- SickKids Foundation (CA)
- Eagle Mount (US)
- Miami Children's Hospital (US)
- Texas Children's Hospital (US)
- Murdoch Children's Research Institute (AU)
- Epilepsy Foundation (AU)
- Sanno Medical Center (JP)
- Austin Health (AU)
- University College London (GB)
Publication Details
- Journal
- Neurology
- Published
- 2026-03-12
- DOI
- https://doi.org/10.1212/wnl.0000000000214760
- Primary Topic
- Epilepsy research and treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00