Other alternative treatment options
Several other HH treatments including stereotactic radiofrequency thermoablation, interstitial radiosurgery, vagus nerve stimulation, and ketogenic diet are discussed below.
Stereotactic Radiofrequency Thermoablation
Stereotactic radiofrequency thermoablation has been used as part of a treatment plan in a relatively small number of patients. This technique involves placement of a depth wire into the HH and physically heating the tip causing destruction to the surrounding HH tissue. Currently there have only been a few cases reported but the results appear promising. Long-term results, however, are not well documented.
Interstitial radiosurgery involves the temporary placement of radioactive seeds into the HH tissue. These radioactive seeds emit gamma radiation with minimal delivery of harmful radiation to normal surrounding structures. As with stereotactic thermoablation, placement of the seeds requires instrumentation into the brain, so the associated risks are still a factor to consider. As with stereotactic radiofrequency thermoablation, the published results of these treatments are limited. Some patients have needed to undergo seed re-implantation in order to achieve the desired results.
Vagus Nerve Stimulation (VNS) and Ketogenic Diet
Vagus Nerve Stimulation and the Ketogenic diet have been suggested as interventions for treating HH. However, there is insufficient evidence about whether they work. In a limited number of reported cases involving VNS, most did not have much success with reducing the overall number of seizures; however, some success was reported when it came to improving rage and autistic type behaviors. The data is even less clear when it comes to the ketogenic diet and its success rate for controlling either HH related seizure activity or behavior.