title: Gelastic epilepsy: Beyond hypothalamic hamartomas.
abstract: Gelastic epilepsy or laughing seizures have been historically related to children with hypothalamic hamartomas. We report three adult patients who had gelastic epilepsy, defined as the presence of seizures with a prominent laugh component, including brain imaging, surface/invasive electroencephalography, positron emission tomography, and medical/surgical outcomes. None of the patients had hamartoma or other hypothalamic lesion. Two patients were classified as having refractory epilepsy (one had biopsy-proven neurocysticercosis and the other one hippocampal sclerosis and temporal cortical dysplasia). The third patient had no lesion on MRI and had complete control with carbamazepine. Both lesional patients underwent resective surgery, one with complete seizure control and the other one with poor outcome. Although hypothalamic hamartomas should always be ruled out in patients with gelastic epilepsy, laughing seizures can also arise from frontal and temporal lobe foci, which can be surgically removed. In addition, we present the first case of gelastic epilepsy due to neurocysticercosis.
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile; Department of Neurology, Hospital Sotero del Río, Santiago, Chile.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Uribe-San-Martin
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile; Department of Neurology, Hospital Sotero del Río, Santiago, Chile.
authors.forename: Ethel
authors.initials: E
authors.lastname: Ciampi
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile; Department of Neurology, Hospital Sotero del Río, Santiago, Chile.
authors.forename: Balduin
authors.initials: B
authors.lastname: Lawson-Peralta
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Keryma
authors.initials: K
authors.lastname: Acevedo-Gallinato
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Torrealba-Marchant
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Manuel
authors.initials: M
authors.lastname: Campos-Puebla
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Jaime
authors.initials: J
authors.lastname: Godoy-Fernández
keywords: Epilepsy surgery; Gelastic epilepsy; Gelastic seizures; Neurocysticercosis