title: Gelastic seizures: incidence, clinical and EEG features in adult patients undergoing video-EEG telemetry.
abstract: This study aimed to determine clinical features of adult patients with gelastic seizures recorded on video -electroencephalography (EEG) over a 5-year period. We screened video-EEG telemetry reports for the occurrence of the term "gelastic" seizures, and assessed the semiology, EEG features, and duration of those seizures. Gelastic seizures were identified in 19 (0.8%) of 2,446 admissions. The presumed epileptogenic zone was in the hypothalamus in one third of the cases, temporal lobe epilepsy was diagnosed in another third, and the remainder of the cases presenting with gelastic seizures were classified as frontal, parietal lobe epilepsy or remained undetermined or were multifocal. Gelastic seizures were embedded in a semiology, with part of the seizure showing features of automotor seizures. A small proportion of patients underwent epilepsy surgery. Outcome of epilepsy surgery was related to the underlying pathology; two patients with hippocampal sclerosis had good outcomes following temporal lobe resection and one of four patients with hypothalamic hamartomas undergoing gamma knife surgery had a good outcome.
authors.affiliation: Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: Stjepana
authors.initials: S
authors.lastname: Kovac
authors.forename: Beate
authors.initials: B
authors.lastname: Diehl
authors.forename: Tim
authors.initials: T
authors.lastname: Wehner
authors.forename: Chiara
authors.initials: C
authors.lastname: Fois
authors.forename: Nathan
authors.initials: N
authors.lastname: Toms
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Walker
authors.forename: John S
authors.initials: JS
authors.lastname: Duncan
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology* / Q000601:surgery; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000453:epidemiology / Q000503:physiopathology*; D017034:Epilepsy, Frontal Lobe / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology / Q000601:surgery; D006222:Hamartoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D007031:Hypothalamus / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000503:physiopathology / Q000601:surgery; D016634:Radiosurgery; D012189:Retrospective Studies; D012640:Seizures / Q000503:physiopathology*; D013686:Telemetry; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery; D006113:United Kingdom / Q000453:epidemiology; D014741:Video Recording; D055815:Young Adult
keywords: Epilepsy surgery; Gelastic seizures; Hypothalamic hamartoma; Temporal lobe epilepsy