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Gelastic epilepsy: Beyond hypothalamic hamartomas.

Reinaldo Uribe-San-Martin1, Ethel Ciampi1, Balduin Lawson-Peralta1

  • 1Department of Neurology, Pontificia Universidad Católica de Chile, Chile; Department of Neurology, Hospital Sotero del Río, Santiago, Chile.

Epilepsy & Behavior Case Reports
|May 20, 2016
PubMed
Summary
This summary is machine-generated.

Gelastic epilepsy (laughing seizures) in adults can originate from frontal or temporal lobes, not just the hypothalamus. Surgical removal of these lesions can lead to seizure control.

Keywords:
Epilepsy surgeryGelastic epilepsyGelastic seizuresNeurocysticercosis

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Area of Science:

  • Neurology
  • Epileptology
  • Neuroimaging

Background:

  • Gelastic epilepsy (laughing seizures) is often associated with hypothalamic hamartomas in children.
  • The etiology and treatment of gelastic epilepsy in adults are less understood.

Purpose of the Study:

  • To investigate the clinical characteristics, imaging findings, and outcomes of gelastic epilepsy in adult patients.
  • To explore potential causes of gelastic epilepsy beyond hypothalamic hamartomas.

Main Methods:

  • Case series of three adult patients with gelastic epilepsy.
  • Utilized brain imaging (MRI), electroencephalography (EEG), and positron emission tomography (PET).
  • Assessed medical and surgical treatment outcomes.

Main Results:

  • None of the three adult patients had hypothalamic hamartomas.
  • Two patients had refractory epilepsy due to neurocysticercosis or hippocampal sclerosis/cortical dysplasia.
  • One patient with no MRI lesion achieved seizure control with carbamazepine.
  • Surgical resection in lesional patients yielded mixed outcomes (one complete control, one poor).
  • Presented the first reported case of gelastic epilepsy secondary to neurocysticercosis.

Conclusions:

  • Gelastic epilepsy in adults can arise from frontal and temporal lobe lesions, distinct from hypothalamic hamartomas.
  • Surgical intervention for lesional gelastic epilepsy may offer seizure control.
  • Neurocysticercosis is a potential, previously unreported cause of gelastic epilepsy.