Patient History

An 18-year-old man was noted soon after birth to have a “genetic syndrome” consisting of syndactyly of his hands and feet. In early childhood he began having laughing spells which were initially thought not to be pathologic. At 8 years of age he had a grand-mal seizure, and evaluation at that time revealed a hypothalamic mass. He continued to have laughing episodes and seizures described as staring spells, grand-mal-type spells, and episodes of an “out of body experience”. They continued despite multiple trials of antiepileptic drugs. He was evaluated at a comprehensive epilepsy care center, and it was determined that his seizures were arising from the hypothalamic lesion. He was referred to our facility for neurosurgical evaluation during which an MRI of his brain was performed. The patient was subsequently taken to the operating room for excision of the mass.