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Hypothalamic hamartomas (HHs) are rare heterotopic masses of aberrant development of normal tissue consisting of a collection of mature neurons, glia, and fiber bundles. Patients with HHs present with a variety of neurological and endocrine disturbances. The hallmark of HHs is gelastic seizures, although other intractable seizures can occur as well. The prevalence of epilepsy due to HH is estimated at 1 to 2 per 100,000 (Neurosurg Focus 2013; 34:E6). Patients with HHs often also have behavioral disorders, precocious puberty, and progressive cognitive decline. In this study, 32 patients (age range, 3.3–39.3 years) underwent preoperative and postoperative neuropsychological evaluation. The average interval between surgery and postoperative ne…