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International Consensus on the Evaluation and Management of : Results From a Modified Delphi Survey

Hypothalamic hamartomas

Hypothalamic hamartomas (HH) are rare developmental brain lesions frequently associated with medically refractory epilepsy and complex neurobehavioral, cognitive and endocrine comorbidities. Due to their rarity, treatment approaches have historically varied, with limited high-quality evidence guiding standardized care. 

Published in Neurology, this international modified Delphi consensus study brought together experts from 17 ILAE Level II epilepsy surgery centers to establish best-practice recommendations for the diagnosis, evaluation and management of HH. The survey evaluated 257 questions across two rounds, achieving consensus on 82% of questions.

Clinical Impact 

This consensus highlights the importance of early referral, protocol-driven evaluation and individualized surgical planning based on lesion size, location and surgical expertise. Findings strongly support a multidisciplinary, coordinated approach to optimize outcomes for children with HH.

John F. Kerrigan, MD, and Angus A. Wilfong, MD, et al., neurologists at Phoenix Children’s, are co-authors of this research, reflecting Phoenix Children’s commitment to advancing evidence-based pediatric epilepsy care and contributing to international clinical standards. Read the Study

Phoenix Children's Epilepsy Program — Arizona's only Level 4 designated pediatric epilepsy center — accepts referrals for children with hypothalamic hamartomas and gelastic epilepsy. To refer a patient or request a consultation, call 602-933-KIDS (5437) or submit a referral online.

REFERENCE

Cohen NT, et al. International Consensus on the Evaluation and Management of Hypothalamic Hamartomas: Results From a Modified Delphi Survey. Neurology. 2026;106(7):e214760. doi:10.1212/WNL.0000000000214760. 

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