To analyze the clinical efficacy of stereotactic-electroencephalography-guided radiofrequency thermocoagulation (SEEG RF-TC) in the treatment of hypothalamic hamartoma (HH) in children.

A retrospective analysis was conducted on the clinical data of 42 children with HH admitted to Neurosurgery Department of Xuanwu Hospital, Capital Medical University from July 2015 to November 2020. All patients underwent stereotactic electroencephalography (SEEG) electrode placement after preoperative evaluation in epilepsy surgery. After completing EEG monitoring, SEEG RF-TC treatment was administered. Regular follow-up visits were conducted at 3, 6, 12, and 24 months after discharge to observe the therapeutic effect and follow-up results of SEEG RF TC. According to the last follow-up results, the children were divided into a cured group and a non-cured group. The incidence of postoperative complications (central fever, diabetes insipidus, electrolyte imbalance) was compared between two groups, and the correlation between HH prognosis and postoperative hypothalamic response was analyzed.

Among the 42 patients, 34 patients were cured (cured group), and 8 patients were not cured (non-cured group), the postoperative seizure free rate was 81.0%, and the epilepsy remission rate was 92.9%. There was no statistically significant difference in preoperative general information between the two groups of patients (P>0.05). Among 42 patients, the incidence of central hyperthermia after surgery was 42.9%, electrolyte imbalance was 4.8%, and diabetes insipidus was 4.8%, mostly a transient reaction. There was a statistically significant difference in the incidence of central hyperthermia between the cured and non-cured groups (P<0.05), while there was no statistically significant difference in the incidence of diabetes insipidus, electrolyte imbalance, and drug cooling (P>0.05). Spearman correlation analysis showed that the prognosis of HH was significantly correlated with central hyperthermia (r=0.315, P<0.05).

SEEG RF-TC treatment is safe and effective for children with HH, and postoperative monitoring of hypothalamic reactions such as central hyperthermia is closely monitored to help children safely pass the perioperative period and improve prognosis.