A gelastic seizure, also known as “gelastic epilepsy”, is a rare type of seizure that involves a sudden burst of energy, usually in the form of laughing or crying. Information regarding gelastic epilepsy, a rare form of epilepsy that involves laughter or crying and is more common in boys than girls. What is Gelastic Epilepsy? Gelastic epilepsy refers to a type of epilepsy in which the seizures are ‘gelastic’, gelastikos being the Greek word for laughter.

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Gelaztic a child also has precocious puberty, this may be treated with hormones, or hormone-like medications. Some associations have been shown between the localization of the HH and the clinical profile, although these are not constant. Left vagal nerve stimulation in children with refractory epilepsy. Successful surgery in these people might improve not only their seizure control, but also improve their behavioral and learning issues.

The mean lesion volume was measured as 1.

Cannon’s student, Philip Bard then showed that this sham rage depended upon the integrity of the hypothalamus. This is likely due to the fact that surgical treatment of hypothalamic hamartomas has been available at specialized centres only over the past 10 years, and consequently treatment could be offered recently to relatively large numbers of previously untreated patients with hypothalamic hamartomas. Autonomic and hormonal ictal changes in gelastic seizures from hypothalamic hamartomas.

Gelastic Epilepsy

In addition, lateral posterior hypothalamic nuclei in rodents have been found to be glutamatergic and project heavily to the basal forebrain and limbic system, particularly to the dentate gyrus and CA-2 of the hippocampus Saper, The patient was treated successfully with carbamazepine.

Taking into account slice thickness and interslice distance in each case, we visualized the distribution of rpilepsy lesion locations using the mammillary level as the point of reference. Dr Stewart Macleod, Specialist Registrar in paediatric neurology.

The second group are large, pyramidal like neurons that hyper-polarize in repose to GABA agonist. Please help to improve this article by introducing more precise citations.

Quiske and colleagues performed comprehensive neuropsychological testing in 13 patients with GS associated with HHs. Patients with hypothalamic hamartomas often become refractory to medications and require surgical treatment with resection, gamma knife or interstitial radiosurgery Regis et al. On the other hand, the localization for dacrystic seizures is similar to patients with GS. This study underscores the fact that certain brain abnormalities other than hypothalamic tumors are also associated with gelastic seizures.


Ng et al eepilepsy Historical note and clinical description of gelastic seizures Laughing seizures were first described by Trousseau The clinical course of patients with gelastic seizures associated with hypothalamic hamartomas is progressive, commencing with gelastic seizures in infancy, deteriorating into more complex seizure disorder resulting in intractable epilepsy.

Heritable syndromes with hypothalamic hamartoma and seizures: Hypothalamic hamartomas — clinical, neuropathological and surgical aspects. GS is the first type of seizure that these patients develop, although other type of seizures are frequently present such as complex partial seizures, generalized tonic-clonic seizures, drop attacks and infantile spasms.

Alternative theories suggest that the epilfpsy neurons could have similarities in morphology and function with neurons from lesions of cortical dysplasia, being potentially epileptogenic Fenoglio et al The clinical spectrum epilfpsy epilepsy in children and adults with hypothalamic hamartoma.

Many of these patients also suffer from cognitive decline, neuropsychiatric comorbidities and precocious puberty. Cases have also been described where that antiepileptic drugs have stopped seizures fully.

Gelastic Epilepsy | Epilepsy Queensland

Finally some authors have presented convincing reports of GS from the temporal area. While some investigators have suggested that the anterior nuclei of the thalamus are critical for the propagation of seizure activity from the hypothalamus Freeman et al. Gamma knife surgery for epilepsy related to hypothalamic hamartomas. The majority of patients with hypothalamic hamartomas develop epilepsy that evolves into multiple seizure types including focal or generalized seizures and concomitant cognitive decline and neuropsychiatric comorbidities Berkovic et al.

Comparative analysis of the available clinical data from patients with gelastic epilepsy only and those with multiple types of seizures i. Oxford University Press is a department of the University of Oxford.

Gelastic Epilepsy: Signs and Information – Disabled World

Mirth, laughter and gelastic seizures. Such information will help us understand the pathophysiology of epilepsy generated in a subcortical tissue such as the hypothalamus and the routes by which it recruits specific brain networks.

Symptomatic and cryptogenic cases. It is common for older children who have gelastic epilepsy caused by a hypothalamic hamartoma to also experience behavioral and learning issues, which usually worsen in the child’s mid-to-late teenage years.

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They found that patients with isolated endocrine issues had pedunculated lesions suspended from the floor of the third ventricle whereas all patients with neurological symptoms had sessile lesions located in the interpeduncular cistern with extension to the hypothalamus.

In some patients the distinction between GS and complex partial seizures can be difficult to ascertain on history and on video analysis Harvey and Freeman In a retrospective review of clinical and structural neuroimaging data from cases of gelastic epilepsy and hypothalamic hamartoma, we aimed to address these questions by analysing the clinical presentation and the neuroanatomical features of the hypothalamic lesions in these patients.

Rekate et al Endoscopic disconnection for hypothalamic hamartoma with intractable seizure. Related articles Gelastic epilepsy hypothalamic hamartoma tuberous sclerosis. What are the exact functional pathways that connect the hypothalamic hamartomas to the adjacent normal hypothalamic, or perhaps remote non-hypothalamic structures?

The endocrinology of hypothalamic hamartoma surgery for intractable epilepsy.

A magnetic resonance imaging MRI scan of the person’s brain should be performed to look for the tumors gelxstic might be found in the hypothalamus in some children who experience gelastic epilepsy. Hypothalamic hamartomas and seizures: Some studies have suggested that small HHs can have less severe seizures, less cognitive problems and a lower frequency of precocious puberty Sturm et al ; Striano et al Evolution and post operative resolution.

Also known as “laughing” seizures, their association with hypothalamic hamartomas is well known in children and adults; however other structural causes have also been implicated. Treatment of patients with gelastic seizures and hypothalamic hamartomas GS are characteristically refractory to medical treatment and the progressing epileptic process eventually leads to deterioration of cognitive and behavioral function Palmini et al They can cause several different types of seizures including a Epile;sy Seizure.

All patients in our cohort were refractory to medical management defined as frequent breakthrough seizures despite trials of three anti-epileptic drugs in therapeutic doses and full compliance.

Recent advances have demonstrated intrinsic epileptogenicity of the HH. The clinical spectrum and natural history of gelastic epilepsy-hypothalamic hamartoma syndrome.