The benign spectrum of hypothalamic hamartomas: Infrequent epilepsy and normal cognition in patients presenting with central precocious puberty

Autor(es):Mostrar menos -

Cukier, Priscilla ^{[1, 2]} ; Martins Castro, Luiz Henrique ^[3] ; Banaskiwitz, Natalie ^[3] ; Teles, Leandro Roberto ^[3] ; Kobuti Ferreira, Luiz Roberto ^[3] ; Adda, Carla Cristina ^[3] ; Leite, Claudia da Costa ^[4] ; Arnhold, Ivo J. P. ^{[1, 2]} ; Mendonca, Berenice Bilharinho ^{[1, 2]} ; Latronico, Ana Claudia ^{[1, 2]} ; Brito, Vinicius Nahime ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Unidade Endocrinol Desenvolvimento, Disciplina Endocrinol, Fac Med, BR-05403900 Sao Paulo - Brazil

^[2] Lab Hormonios Genet Mol LIM 42, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Div Neurol, Hosp Clih, Fac Med, BR-05403900 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Dept Radiol, Fac Med, BR-05403900 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: SEIZURE-EUROPEAN JOURNAL OF EPILEPSY; v. 22, n. 1, p. 28-32, JAN 2013.
• Citações Web of Science: 6

Resumo

Purpose: Hypothalamic hamartoma (HH) is the main structural cause of central precocious puberty (CPP). HH is frequently associated with cognitive impairment and epileptic encephalopathies. Disease severity in case series from neurology services may be biased towards more neurologically impaired patients. Aim: To perform a prospective cognitive evaluation in patients with HH presenting with CPP in an endocrinology outpatient clinic setting. Methods: We evaluated fifteen consecutive patients with CPP due to HH presenting to an endocrinology outpatient clinic. CPP was diagnosed at a median age of 0.7 yr (0.4-7 yr). Mean age at neurologic evaluation was 13.9 yrs. Eight patients (53.3%) were male. Epileptic seizures occurred in 5/15 (33%) patients. Two patients presented a single unprovoked seizure (SUS). Three patients were diagnosed with epilepsy. Cognitive evaluation, using age-appropriate Wechsler Intelligence Scale, was performed in 11 patients. Results: All patients without epilepsy, including two patients with a history of a SUS, had normal neurologic and cognitive evaluation. Epilepsy and SUS were only seen in patients with sessile HH. Three patients with epilepsy presented cognitive or behavioral findings. Reduced intelligence quotients (IQ), in the borderline range, were noted in both patients with epilepsy who underwent full cognitive evaluation. We found no significant correlation between HH diameter or shape and mean full-scale IQ. Conclusions: Patients who presented with isolated CPP without epilepsy displayed normal cognition when evaluated after a mean period of 13 years. Occurrence of epilepsy, seen in a minority of patients, but not of a single seizure, was associated with mild cognitive deficit and behavioral disturbances in this case series. (C) 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved. (AU)

• Processo FAPESP: 06/56531-0 - Mecanismos moleculares envolvidos no início da puberdade humana: análise dos genes EAP-1 e TTF-1 em pacientes com distúrbios puberais centrais
• Beneficiário: Priscilla Cukier Kaczemorska
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto