title: Different localizations underlying cortical gelastic epilepsy: case series and review of literature.
abstract: BACKGROUND
  Gelastic seizures (GS) are classically observed with hypothalamic hamartomas but they can also be associated with cortical epileptogenic foci.
  
  
  OBJECTIVE
  To study the different cortical localizations associated with GS.
  
  
  METHODS
  We reviewed the data from all patients with cortical GS investigated in our epilepsy unit from 1974 to 2012 and in the literature from 1956 to 2013.
  
  
  RESULTS
  Sixteen cases were identified in our database and 77 in the literature. Investigations provided confident focus localization in 9 and 18, respectively. In our series, the identified foci were located in the mesial temporal structures (2 left, 1 right), lateral temporal cortex (1 right), superior frontal gyrus (1 left), and operculoinsular region [3 right (orbitofrontal or frontal operculum extending into the anterior insula) and 1 left (frontal operculum extending into the anterior insula)]. In the literature, the identified foci (13 right/5 left) were located in the temporal lobe of 4 (1 right inferior, 1 right medial and inferior, 1 right posterior middle, inferior extending posteriorly to the lingual gyrus, and 1 left middle, inferior, and medial), in the frontal lobe of 12 [10 (6 right/4 left) medial (i.e., superior, medial frontal, and/or anterior cingulate gyri), 1 lateral (right anterior inferior frontal gyrus), and 1 right medioposterior orbitofrontal cortex] and in the parietal lobe of 2 (1 left superior parietal lobule and 1 right parietal operculum) patients.
  
  
  CONCLUSIONS
  Ictal laughter is a poorly lateralizing and localizing feature as it may be encountered in patients with a focus in the left or right frontal, temporal, parietal, or insular lobe.
authors.affiliation: Division of Neurology, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada.
authors.forename: Thi Phuoc Yen
authors.initials: TP
authors.lastname: Tran
authors.affiliation: Division of Neurosurgery, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada.
authors.forename: Van Tri
authors.initials: VT
authors.lastname: Truong
authors.affiliation: Division of Neurology, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada.
authors.forename: Maxym
authors.initials: M
authors.lastname: Wilk
authors.affiliation: Division of Neurology, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada.
authors.forename: Tania
authors.initials: T
authors.lastname: Tayah
authors.affiliation: Division of Neurosurgery, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Bouthillier
authors.affiliation: Department of Paediatrics, IWK Health Center, Dalhousie University, Halifax, NS, Canada.
authors.forename: Ismail
authors.initials: I
authors.lastname: Mohamed
authors.affiliation: Division of Neurology, Centre Hospitalier Université de Montréal (Hôpital Notre-Dame), Montreal, QC, Canada. Electronic address: d.nguyen@umontreal.ca.
authors.forename: Dang Khoa
authors.initials: DK
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012189:Retrospective Studies; D055815:Young Adult
keywords: Epilepsy surgery; Gelastic epilepsy; Gelastic seizures; Laughter