What Is a Gelastic Seizure?

A gelastic seizure is a type of epilepsy that manifests itself in the form of emotional outburst, usually with unexplained laughing or crying. The root of the word gelastic is gelos, a Greek word that means laughter. Such seizures typically occur very suddenly and the person having the seizure has no control over the event. Since a gelastic seizure is very rare and the symptoms are so peculiar, it is not unusual for a person with this condition to go for quite some time before getting the diagnosis.

When a person has a gelastic seizure, he or she may suddenly begin laughing or crying, often quite loudly. This can occur at any time, regardless of the surroundings. People who have these seizures without knowing the cause are often embarrassed by them, since they may seem more like inappropriate behavior than epilepsy. Typically the first gelastic seizure occurs before a child is three years old, but it can occur in older people as well.

A gelastic seizure may be followed by other types of seizure activity, including stiffness or twitching, or there may be no other signs of a problem. In many cases the person having the seizure is fully aware of everything that is going on, but may be puzzled as to why he or she is laughing or crying. Other times the person may be completely unaware that there is a problem and have no memory of the event. In most cases these episodes usually last a minute or less, often taking only five or 10 seconds from start to finish, making them harder to diagnose, though in some cases they can last much longer.

Children who have this illness may get progressively worse as they get older, though in varying ways, depending on the cause of the seizures. They may lose cognitive function, experience the very early onset of puberty, or have significant behavioral problems. It is important to diagnose the problem as soon as possible so that treatment can be started quickly.

It is possible that a hypothalamic hamartoma, a type of brain tumor, is the underlying problem behind a gelastic seizure. This is a benign tumor that grows in the glial cells near the hypothalamus and may be responsible for the appearance of various types of seizures, including gelastic seizures. Other causes of this disorder are frontal lobe lesions and hemangiomas. Diagnosis is usually made with either a computerized tomography (CT scan) or magnetic resonance imaging (MRI).

Treatment for this illness depends on exactly what is causing the problem. In some cases medication such as dextroamphetamine, Phenobarbital, and primidone may be used together to help to control the frequency and severity of the seizures. If a tumor is the cause it may require surgery or radiation treatment, especially if symptoms other than the gelastic seizure appear.