A Girl Who is Smiling for no Reason: Gelastic Seizure- A Case Report

Nikhil Agrawal,Subodh Sharma Paudel

doi:10.3126/jnps.v39i3.28673

Abstract

Being a rare disorder, Gelastic seizure primarily presents as episodes of sudden occurrence of emotions usually associated with laugh or giggle due to facial contractions. A child presented with abnormal body movement in the form of smiling and uprolling of eyes, which was clinically diagnosed as gelastic seizure, a rare form of a very common presentation, epilepsy. The case is presented to highlight abnormal posturing and smiling episodes in a child can be a form of seizure episode, which generally presents with a diagnostic dilemma and therapeutic nightmare to the clinician.

Highlights

Gelastic seizure is a rare form of seizure disorder that primarily presents as episodes of sudden occurrence of emotions usually associated with laugh or giggle due to facial contractions.[1]
If any exact focal localisation of seizure is not found, it is categorised as cryptogenic localisation related epilepsy (LRE).[2]
We present a case of gelastic seizure who had presented to us with bouts of laughter events

Summary

INTRODUCTION

Gelastic seizure is a rare form of seizure disorder that primarily presents as episodes of sudden occurrence of emotions usually associated with laugh or giggle due to facial contractions.[1]. A four years old girl with no significant past history presented to our OPD with complaints of abnormal movements of upper and lower limbs, up-rolling of eyes and abnormal smiling expression for more than one month This lasted for a minimum of five seconds and maximum up to two minutes with an average of eight to 10 episodes per day, associated with loss of consciousness. Instead of seeking medical advice, she was taken for traditional modes of treatment, which was of no avail to her ailment On examination, she was alert, active and oriented with normal anthropometry, general and systemic examination. The provisional diagnosis of seizure disorder with smiling episodes was made All her blood investigations were within normal limits. The patient’s parents were counselled about the cryptogenic nature of the disorder and its guarded prognosis

DISCUSSION

CONCLUSIONS