Gelastic seizures

Article type: Research Article

Authors: Gordon, Neil

Affiliations: Retired, The Children's Hospitals, Manchester, United Kingdom

Note: [] Correspondence: Neil Gordon, M.D. FRCP, HonFRCPCH. Huntlywood 3 Styal Road Wilmslow SK9 4AE United Kingdom Tel: 0 16 25 525437; E-mail: [email protected]

Abstract: The symptoms associated with gelastic seizures are discussed, as well as their most frequent origin in hypothalamic hamartoma. Complications, especially cognitive and behaviour disorders, often occur, and causes for these are suggested. Sometimes the laughter is accompanied by feeling of mirth, and sometimes it is not, and this seems to depend on the parts of the cerebral cortex affected by the epileptic discharges. Precocious puberty often occurs in affected patients. Some of the possible causes for this are considered, and findings which suggest the diagnosis. The pathology responsible for gelastic seizures can vary, but most commonly it is a developmental anomaly in the hypothalamic area, and rarely a neoplasm. Other structural lesions in the central nervous system may well occur. The differential diagnosis is considered, and the possibilities of treatment. Surgery should be considered at an early age, particularly if the seizures do not respond to medical treatment, as if successful the child's quality of life can be greatly improved. The decision on the type of operation to be used may best be made on an individual basis depending on the type and site of the lesion; and the risks involved. The development of stereotactic radiosurgery may be the best hope for the future. (J Pediatr Neurol 2003; 1(2): 69–73).

Keywords: gelastic seizures, hypothalamic hamartoma, symptoms, diagnosis, treatment

Journal: Journal of Pediatric Neurology, vol. 1, no. 2, pp. 69-73, 2003