Gelastic epilepsy: Beyond hypothalamic hamartomas
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Date
2015
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Abstract
Gelasticepilepsyorlaughingseizureshavebeenhistoricallyrelatedtochildrenwithhypothalamichamartomas. Wereportthreeadultpatientswhohadgelasticepilepsy,definedasthepresenceofseizureswithaprominent laughcomponent,includingbrainimaging,surface/invasiveelectroencephalography,positronemissiontomography,andmedical/surgicaloutcomes.Noneofthepatientshadhamartomaorotherhypothalamiclesion.Two patientswereclassifiedashavingrefractoryepilepsy(onehadbiopsy-provenneurocysticercosisandtheother onehippocampalsclerosisandtemporalcorticaldysplasia).ThethirdpatienthadnolesiononMRIandhad completecontrolwithcarbamazepine.Bothlesionalpatientsunderwentresectivesurgery,onewithcomplete seizurecontrolandtheotheronewithpooroutcome.Althoughhypothalamichamartomasshouldalways beruledoutinpatientswithgelasticepilepsy, laughingseizurescanalsoarisefromfrontalandtemporal lobefoci,whichcanbesurgicallyremoved. Inaddition,wepresentthefirstcaseofgelasticepilepsydueto neurocysticercosis.
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Keywords
Gelastic epilepsy, Gelastic seizures, Epilepsy surgery, Neurocysticercosis