Narayana Health SRCC Children’s Hospital Successfully Treats Rare Hypothalamic Hamartoma Mass Causing Epilepsy in 5-Year-Old Girl
Mumbai: Narayana Health SRCC Children’s Hospital, Mumbai, successfully treated a rare case of Hypothalamic Hamartoma using stereotactic radio frequency ablation technique in a five-year-old girl. A multidisciplinary team – comprising a paediatric neurosurgeon, paediatric neurologist, paediatric endocrinologist, neuropsychologists – led by Dr Saurav Samantray Senior Consultant- Paediatric Neurosurgery and Dr .Pradnya Gadgil Senior Consultant- Paediatric Neurology,Mumbai
The child was presented to Dr. Pradnya Gadgil at Narayana Health SRCC Children’s Hospital OPD a few months back, with complaints of frequent seizures – up to 15 a day – and of multiple types with the gelastic seizure (laughter seizure) being the most prominent. She developed behavioural issues in the form of irritability and hyperactivity. She was on medications for precocious puberty too.
The child underwent a prolonged video EEG recording to capture and analyse the seizures. An Epilepsy Protocol MRI was done to delineate the anatomy of the hypothalamic hamartoma, a congenital benign abnormal mass of tissue in the hypothalamus, which is the seat of hormonal regulation, temperature regulation, hunger and thirst control, behaviour, etc. It is also the origin of the gelastic seizures which were observed in this child. A detailed hormonal evaluation was also done.
The young patient had been experiencing uncontrollable gelastic (laughing) seizures since she was a six-month-old infant. These episodes were misinterpreted as normal behaviour for a prolonged period, delaying diagnosis. Later, signs of early puberty, including vaginal bleeding and breast bud development, pointed to hormonal disruption.
An MRI revealed a rare Hypothalamic Hamartoma—a benign, congenital mass in the hypothalamus responsible for both her seizures and hormonal symptoms. Despite multiple medications, the child continued to suffer 10–15 seizures daily, along with behavioural issues like irritability and hyperactivity.
Dr. Saurav Samantray, Senior Consultant- Paediatric Neurosurgery, Narayana Health SRCC Children’s Hospital, Mumbai explained, “Treating a Grade III hypothalamic hamartoma surgically is inherently risky because of its deep-seated location near vital structures like the brain stem and optic tracts. Traditional open surgery carries a 30 per cent risk of complications such as paralysis, vision loss, or hormonal dysfunction. With RFA, we used millimetre-precision guided electrodes through five 2mm skull openings, allowing us to ablate the lesion safely. Planning was meticulous and executed using stereotactic software over several hours. This approach significantly reduced risk and allowed us to achieve complete seizure cessation post-surgery.”
He further added, “The surgery lasted approximately four hours under general anesthesia. Post-operatively, the child regained full consciousness within an hour, resumed oral feeds by the fourth hour, and experienced no complications. Remarkably, her seizures stopped immediately after the procedure—a dramatic improvement from her previous 10–15 episodes per day. She was discharged on the fifth post-operative day, fully alert, mobile, and stable.”
This case is a testament to Narayana Health SRCC Children’s Hospital’s leadership in advanced paediatric neurosurgery. Very few centres in India currently offer Stereotactic RFA due to its complexity and requirement for high-precision execution by a specialised team. The hospital remains committed to pushing the boundaries of minimally invasive paediatric care.
Dr. Pradnya Gadgil, Senior Consultant- Paediatric Neurology, Narayana Health SRCC Children’s Hospital,Mumbai who managed the child’s neurological and endocrine concerns, added:
“This case is a milestone in paediatric epilepsy care. The child had been suffering since infancy with seizures that impacted her behaviour and development. With early surgical intervention using advanced technology like RFA, we were able to prevent further cognitive and behavioural deterioration. For other patients facing similar conditions, this treatment modality sets a new standard—it’s precise, minimally invasive, and remarkably effective when performed by an experienced, multidisciplinary team.”
Dr. Zubin Pereira, Facility Director, Narayana Health SRCC Children’s Hospital, Mumbai ,stated: “This case exemplifies our commitment to offering world-class, multidisciplinary paediatric care using the latest technology. Our focus remains on minimising patient risk while maximising outcomes. We are proud to be among the few centres in India capable of performing such high-precision interventions, reaffirming our position as a leader in advanced paediatric neurosurgery.”
