Preview

Epilepsy and paroxysmal conditions

Advanced search

GELASTIC SEIZURES

Full Text:

Abstract

Abstract: gelastic seizures are focal epileptic seizures that involve sudden outbursts of forced laughter. In our study Gelastic seizures were revealed in 25 patients that comprised 1,98% of all epilepsy events with onset under 18 years of age (n=1261). Male patients prevailed in the group: 16 male patients (64.0%) against 9 female patients (36.0%). Symptomatic focal epilepsy was identified most frequently - in 80% of patients. Cryptogenic focal epilepsy (probably symptomatic focal epilepsy) was defined in 20% of cases. Epilepsy onset varied in a broad age interval: from the first day after birth till 16 years, 4.53+4.52 years on average. Most often (82%) onset was observed in the first years of life - from the first days of life till 6 years old. Clinical findings may disclose 12 different types of seizures. Most frequently were observed: focal motor seizures with typical automatisms - 64% of cases, secondarily generalized tonic-clonic seizures - 48% of cases and tonic seizures - in 32% of all cases. MRI changes: hypothalamic hamartoma - 32% of cases, temporal lobe atrophy - 12% of cases, DNET - 8% of cases, focal cortical dysplasia (insular-opercular region) - 4%, local bifrontal atrophy - 8%, Tuberous Sclerosis - 8% of cases, diffuse cerebral atrophy presented in the form of ventriculomegalia was diagnosed in 2 patients - 8% of cases. Remission was achieved only in 24% of cases. Whereas, in 12% of cases seizures were blocked only after surgical intervention. Reduction of seizures frequency >50% was observed in 20% of patients. In 56% of cases AED therapy produced no significant effect.

About the Authors

M. B. Mironov
Svt. Lukas Institute of Child Neurology and Epilepsy, Moscow
Russian Federation


I. V. Ivanova
Svt. Lukas Institute of Child Neurology and Epilepsy, Moscow
Russian Federation


K. Yu. Mukhin
Svt. Lukas Institute of Child Neurology and Epilepsy, Moscow
Russian Federation


References

1. Zenkov L.R. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005; 105 (10): 52-54.

2. Karlov V.A., Andreeva O.V. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2006; 106 (6): 62-69.

3. Mironov M.B., Mukhin K.Yu., Kakaulina V.S. Farmateka. 2012; 1: 67-71

4. Mukhin K.Yu., Mironov M.B., Tysyachina M.D., Alikhanov A.A., Petrukhin A.S. Russkii zhurnal detskoi nevrologii. 2006; 1 (1): 6-17.

5. Mukhin K.Yu., Mironov M.B., Petrukhin A.S. Epileptic syndromes. Diagnosis and therapy. Guide for physicians. [Epilepticheskie sindromy. Diagnostika i terapiya. Rukovodstvo dlya vrachei]. Moscow. 2014; 376 s.

6. Petrukhin A.S., Pylaeva O.A., Voronkova K.V. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005; 105 (9): 66-70.

7. Usacheva E.L., Mukhin K.Yu., Prityko A.G., Aivazyan S.O., Kharlamov D.A., Shorina M.Yu. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2003; 103 (1): 10-16.

8. Akman C.I., Schubert R., Duran M., Loh J. Gelastic seizure with tectal tumor, lobar holoprosencephaly, and subependymal nodules: clinical report. J. Child. Neurol. 2002; 17: 152-154.

9. Alikchanov A.A., Petrukhin A.S., Mukhin K.Yu., Nikanorov A.Yu. Gelastic epilepsy, hypothalamic hamartoma, precocious puberty, and agenesis of the corpus callosum: a new association. Brain. Dev. 1998 Jun; 20 (4): 239-41.

10. Arroyo S., Lesser R.P., Gordon B., Uematsu S., Hart J., Schwerdt P., Andreasson K., Fisher R.S. Mirth, laughter and gelastic seizures. Brain. 1993 Aug; 116 (4): 757-80.

11. Arroyo S., Santamar í a J., Sanmart í F., Lomena F., Catafau A., Casamitjana R., Setoain J., Tolosa E. Ictal laughter associated with paroxysmal hypothalamopituitary dysfunction. Epilepsia. 1997 Jan; 38 (1): 114-7.

12. Arzimanoglou A.A., Hirsch E., Aicardi J. Hypothalamic hamartoma and epilepsy in children: illustrative cases of possible evolutions. Epileptic Disord. 2003; 5: 187-99.

13. Assal G., Majdalani A., Gautier J.C. Gelastic epilepsy. Probable diencephalichamartoma. Rev Neurol. Paris. 1993; 149 (4): 291-3.

14. Bancaud J., Talairach J., Bonis A., Buser P., Geier S. Generalized crises, gelastic epilepsy and temporal tumor . Rev Electroencephalogr Neurophysiol Clin. 1974 Jan-Mar; 4 (1): 163-74.

15. Berkovic S.F., Andermann F., Melanson D., Ethier R.E., Feindel W., Gloor P. Hypothalamic hamartomas and ictal laughter: evolution of a characteristic epileptic syndrome and diagnostic value of magnetic resonance imaging. Ann Neurol. 1988 May; 23 (5): 429-39.

16. Brandberg G., Eeg-Olofsson O. Gelastic seizures. ILAE website. Date of submission: 2001 April 19.

17. Chao D, Druckman R. Laughter in epilepsy. Neurology. 1957 Jan; 7 (1): 26-36.

18. Chen R.C., Forster F.M. Cursive epilepsy and gelastic epilepsy. Neurology. 1973 Oct; 23 (10): 1019-29.

19. Clements B.G., Bossard J.W., Bickford R.G. Auras of pain and pleasure (sound motion picture recording of seizures in two patients). EEG Clin Neurophysiol. 1957; 9: 571.

20. Cook T., Joshi C. Gelastic seizures in tuberous sclerosis complex: case report and literature review. J Child Neurol. 2011 Jan; 26 (1): 83-6.

21. Daly D.D., Mulder D.W. Gelastic epilepsy. Neurology 1957; 7: 189-92.

22. Delalande O.R., Fohlen M.J., Jalin C. et al. Surgical treatment of epilepsy due to hypothalamic hamartoma: Technique and preliminary results in five cases. Epilepsia 1998; 39 (6): 90-91.

23. Dericioglu N., Cataltepe O., Tezel G.G., Saygi S. Gelastic seizures due to right temporal cortical dysplasia. Epileptic Disord. 2005 Jun; 7 (2): 137-41.

24. Devinsky O., Morrell M.J., Vogt B.A. Contributions of anterior cingulate cortex to behaviour. Brain. 1995; 118: 279-306.

25. Diebler C., Ponsot G. Hamartomas of the tuber cinereum. Neuroradiology. 1983; 25 (2): 93-101.

26. Dott N.M. Surgical aspects of the hypothalamus, in: W.E. Le Gros Clark, J. Beatti, G. Riddoch, N.M. Dott (Eds), The hypothalamus. Morphological, functional, clinical and surgical aspect. Oliver and Boyd. London, 1938: 131-185.

27. Freeman J.L., Harvey A.S., Rosenfeld J.V., Wrennall J.A., Bailey C.A., Berkovic S.F. Generalized epilepsy in hypothalamic hamartoma: evolution and postoperative resolution. Neurology. 2003 Mar 11; 60 (5): 762-7.

28. Gascon G.G., Lombroso C.T. Epileptic (gelastic) laughter. Epilepsia. 1971; 12: 63-76.

29. Gastaut H. & Zifkin B.G. Secondary bilateral synchrony and Lennox-Gastaut syndrome. In: The Lennox-Gastaut syndrome (Neurology and neurobiology, Vol. 45). Eds. E. Niedermeyer & R. Degen. New York. 1988; 221-242.

30. Gordon B.H.J.J., Lesser R.P., Arroyo S. Mapping cerebral sites for emotion and emotional expression with direct cortical electrica stimulation and seizure discharges. New York. Elsevier Science. 1996.

31. Gunatilake S., De Silva D.G. Laughing seizures due to a midline intraventricular neoplasm in tuberous sclerosis. Arch Dis Child. 1995 May; 72 (5): 443-4.

32. Hahn A., Fischenbeck A., Stephani U. Induction of epileptic negative myoclonus by oxcarbazepine in symptomatic epilepsy. Epileptic Disord 2004; 6: 271-4.

33. Iannetti P., Chessa L., Raucci U., Basile L.A., Fantozzi L.M., Bozzao L. Gelastic epilepsy. A linical contribution. Clin Pediatr (Phila). 1992 Aug; 31 (8): 467-70. Review.

34. Jacome D.E., McLain L.W., Fitzgerald R. Postural reflex gelastic seizures. Arch Neurol 1980; 37: 249-51.

35. Jandolo B., Gessini L., Occipinti E. et al. Laughing and running fits as manifestations of early traumatic epilepsy. Eur Neurol. 1977; 15: 177-82.

36. Kahane P., Munari C., Minotti L. et al. The role of the hypothalamic hamartoma in the genesis of gelastic and dacrystic seizures. In: Tuxhorn I., Holthausen H., Boenigk K., eds, Paediatric epilepsy syndromes and their surgical treatment. London. 1997: 447-61.

37. Kim S.H., Kim K., Min J.W., Yoo B.G., Yoo K.M. Gelastic Seizures in a Patient with Tuberous Sclerosis. J Korean Epilepsy Soc. 2002 Dec; 6 (2): 150-153.

38. Kurle P.J., Sheth R.D. Gelastic seizures of neocortical origin confirmed by resective surgery. J Child Neurol. 2000 Dec; 15 (12): 835-8.

39. Kuzniecky R., Guthrie B., Mountz J., Bebin M., Faught E., Gilliam F., Liu H.G. Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol. 1997 Jul; 42 (1): 60-7.

40. Lehtinen L, Kivalo A. Laughter epilepsy. Acta Neurol Scand. 1965; 41: 255-261.

41. List C.F., Dowman C.E., Bagchi B.K., Bebin J. Posterior hypothalamic hamartomas and gangliogliomas causing precocious puberty. Neurology. 1958 Mar; 8 (3): 164-74.

42. Loiseau P., Cohadon F., Cohadon S. Gelasticepilepsy. A review and report of five cases. Epilepsia. 1971 Dec; 12 (4): 313-323.

43. Machado R.A., Astencio A.G. Gelastic seizures involving the left parietal lobe. Epilepsy Behav. 2012 Jan; 23 (1): 87-9.

44. Mohamed I.S., Otsubo H., Shroff M. et al. Magnetoencephalography and diffusion tensor imaging in gelastic seizures secondary to a cingulate gyrus lesion. Clin Neurol Neurosurg. 2007; 109: 182-7.

45. Mullatti N., Selway R., Nashef L. et al. The clinical spectrum of epilepsy in children and adults with hypothalamic hamartoma. Epilepsia. 2003; 44: 1310-9.

46. Munari C.K.P., Francione S. Role of the hypothalamic harmatoma in the genesis of gelastic fits (a video-stereo EEG study). EEG ClinNeurophysiol. 1997; 95: 154-60.

47. Nanba Y., Maegaki Y. Epileptic negative myoclonus induced by carbamazepine in a child with BECTS. Benign epilepsy with centrotemporal spikes. Pediatr Neurol 1999; 21: 664-7.

48. Nicolae L., Iacob G., Poparda M., Popescu B.O. Case report. Gelastic seizures in a patient with right gyruscinguli astrocytoma. J Med Life. 2010 Oct-Dec; 3 (4): 433-6.

49. Oehl B., Biethahn S., Schulze-Bonhage A. Mirthful gelastic seizures with ictal involvement of temporobasal regions. Epileptic Disord. 2009 Mar; 11 (1): 82-6.

50. Palmini A., Chandler C., Andermann F., Costa Da Costa J., Paglioli-Neto E., Polkey C., Rosenblatt B., Montes J., Martínez J.V., Farmer J.P., Sinclair B., Aronyk K., Paglioli E., Coutinho L., Raupp S., Portuguez M. Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology. 2002 May 14; 58 (9): 1338-47.

51. Panagariya A., Sharma B., Tripathi G., Kumar H., Agarwal V. Gelastic epilepsy associated with lesions other than hypothalamic hamartoma. Ann Indian Acad Neurol 2007; 10: 105-8.

52. Parmeggiani L., Seri S., Bonanni P., Guerrini R. Electrophysiological characterization of spontaneous and carbamazepine-induced epileptic negative myoclonus in benign childhood epilepsy with centro-temporal spikes. Clin Neurophysiol. 2004; 115: 50-8.

53. Plouin P., Ponsot G., Dulac O., Diebler C., Arthuis M. Hypothalamic hamartomas and laughing seizures. Rev Electroencephalogr Neurophysiol Clin. 1983 Dec; 13 (3): 312-6.

54. Ray A., Kotagal P. Temporal lobe epilepsy in children: overview of clinical semiology. Epileptic Disord. 2005 Dec; 7 (4): 299-307.

55. Satow T., Usui K., Matsuhashi M., Yamamoto J., Begum T., Shibasaki H. et al. Mirth and laughter arising from human temporal cortex. J Neurol Neurosurg Psychiatry. 2003; 74: 1004-5.

56. Sethi P.K., Rao T.S. Gelastic, quiritarian, and cursive epilepsy: a clinicopathological appraisal. J Neurol Neurosurg Psychiatry. 1976; 39: 823-8.

57. Sher P.K., Brown S.B. Gelastic Epilepsy. Onset in neonatal period. Am J Dis Child. 1976 Oct; 130 (10): 1126-31.

58. Shin H.Y., Hong S.B., Joo E.Y., Tae W.S., Han S.J., Cho J.W., Seo D.W., Kim S.H., Lee J.M., Kim S.I. Gelastic seizures involving the right parietal lobe. Epileptic Disord. 2006 Sep; 8 (3): 209-12.

59. Striano S., Barbieri F., Bilo L., Meo R., Ruosi P., Soricellis M. Recurrent frontal status epilepticus with poly morphic clinical features. A case report. Acta Neurol (Napoli). 1990 Jun; 12 (3): 193-9.

60. Striano S., Meo R., Bilo L., Cirillo S., Nocerino C., Ruosi P., Striano P., Estraneo A. Gelastic epilepsy: symptomatic and cryptogenic cases. Epilepsia. 1999 Mar; 40 (3): 294-302.

61. Tassinari C.A., Riguzzi P., Rizzi R., Passarelli D., Volpi L. Gelastic seizures. In: Tuxhorn I., Holthausen H., Boenigk H. eds. Paediatric epilepsy syndromes and their surgical treatment. John Libbey& Company Ltd. 1997; 429-46.

62. Teraoka S., Imai K, Mano T, Okinaga T, Matsuoka T, Ono J., Hira-buki N., Abe J and Okada Sh. Magnetoencephalographic Analysis of Gelastic Seizures in a Patient with Tuberous Sclerosis. Epilepsia. May 1998; 39 (5): 82.

63. Tohshin G.O. Acth treatment for gelasticseizures. Arch Dis Child. 1999; 81: 278.

64. Trousseau A. De lepilepsie, Clinique Medicalede LHotel-Dieude Paris.1877: 89-155.

65. Umeoka S., Baba K., Mihara T. Symptomatic laughter in a patient with orbitofrontal seizure: a surgical case with intracranial electroencephalographic study: case report. Neurosurgery. 2008; 63 (6): E1205, 6; discussion E1206.

66. Unnwongse K., Wehner T., Bingaman W., Foldvary-Schaefer N. Gelastic seizures and the anteromesial frontal lobe: a case report and review of intracranial EEG recording and electrocortical stimulation case studies. Epilepsia. 2010 Oct; 51 (10): 2195-8.

67. Yamamoto N., Watanabe K., Negoro T., Furune S., Takahashi I., Nomura K., Matsumoto A. Partial seizures evolving to infantile spasms. Epilepsia. 1988 Jan-Feb; 29 (1): 34-40.


For citation:


Mironov M.B., Ivanova I.V., Mukhin K.Y. GELASTIC SEIZURES. Epilepsy and paroxysmal conditions. 2014;6(3):20-29. (In Russ.)

Views: 326


ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)