Gelastic epilepsy associated with lesions other than hypothalamic hamartoma

Abstract

Gelastic epilepsy is a rare but well recognized epileptic syndrome typically manifesting in early childhood. It is characterized by recurrent brief seizures with initial laughter or grimacing. 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. This study reports three cases of gelastic seizures, one each of Tuberous sclerosis, Left temporal gliosis and Hypothalamic Hamartoma with neuronal migration defect respectively. Though these seizures are usually pharmacoresistant and may end up as a severe epileptic encephalopathy and catastrophic epilepsy of childhood, all of our cases responded well to antiepileptic medication (carbamazepine and valproate). This study underscores the fact that certain brain abnormalities other than hypothalamic tumors are also associated with gelastic seizures. The clinical characteristic of seizures in these patients is different than those of isolated hypothalamic hamartomas and that these seizures can be well controlled with antiepileptic drugs.