Gelastic Epilepsy A Review and Report of Five Cases

Loiseau, P; Cohadon, F; Cohadon, S

doi:10.1111/j.1528-1157.1971.tb04379.x

Cited by 67 publications

(52 citation statements)

References 12 publications

(13 reference statements)

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“…Removal of such lesions have been reported to resume pathological laughter 1 . Several epileptic disorders have been implicated with pathological laughter as well, which can be summarized as patients with complex partial seizures of suspected temporal origin and patients with hypothalamic hamartomas and gelastic seizures 9 .…”

Section: Discussionmentioning

confidence: 99%

Pathological laughter in a patient with trigeminal neurinoma

Machado

Aguiar

Marino

2002

Arq. Neuro-Psiquiatr.

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-We present a 47-year-old woman with a long history of anxiety and a more recent history of shock-like facial pain and episodes of laughter without any motivation. She could not explain the laughing bursts and did not have a sense of mirth preceding it. On neurological examination she presented a VI nerve palsy and trigeminal hypoesthesia (V2 and V3) on the right side. Magnetic resonance imaging exhibited a large cystic lesion on the right middle fossa causing significant compression on the brain stem. A frontoorbitozygomatic and pretemporal combined approach was performed. During intra and extradural exploration a large tumor was found on the trigeminal nerve. The whole lesion was resected, revealing to be a neurinoma on pathological exhamination. She maintained a VI nerve palsy but had complete remission of the unmotivated laughing episodes during the one year follow up.KEY WORDS: pathological laughter, neurinoma, trigeminal neuralgia. Riso patológico em uma paciente com neurinoma de trigêmeoRESUMO -Relatamos o caso de uma paciente de 47 anos com história de longa data de ansiedade que apresentou início de dor facial em choques do lado direito e episódios de riso sem motivação. Ela não podia explicar os episódios de riso e não percebia uma sensação de graça que os precedia. Ao exame neurológico apresentava paresia do VI nervo e hipoestesia no trajeto dos ramos oftálmico e maxilar do trigêmeo. A ressonância magnética de encéfalo apresentava uma lesão cística na fossa média direita causando significativo efeito de massa sobre o tronco encefálico. Um acesso combinado fronto-orbito-zigomático e pré-temporal foi realizado e a exploração intra e extra-dural revelou um grande tumor no nervo trigêmeo. Toda a lesão foi ressecada, revelando ser um neurinoma no exame patológico. A paciente manteve a paresia de VI nervo mas apresentou remissão completa dos episódios de riso imotivado durante o seguimento de um ano. PALAVRAS-CHAVE: riso patológico, neurinoma, neuralgia trigeminal.

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Section: Discussionmentioning

confidence: 99%

Pathological laughter in a patient with trigeminal neurinoma

Machado

Aguiar

Marino

2002

Arq. Neuro-Psiquiatr.

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“…We examined whether or not there was any relationship between etiology and each of the following 21 factors: (1) age at onset, (2) birth weight, (3) age of the mother, (4) number of siblings, (5) delayed development before the onset of spasms, (6) convulsions before the onset of spasms, (7) neurological abnormalities, (8) pneumoencephalographie abnormalities, (9) series (cluster) formation of the spasms, (10) laughing attacks, (11) sex, (12) pregnancy abnormalities, (13) delivery abnormalities, (14) neonatal abnormalities, (15) response to ACTH therapy, (16) relapse of seizures after ACTH therapy, (17) evolution into other types of fits, (18) seizures concomitant with spasms, (19) family history of epilepsy and other convulsive disorders, (20) seizure cessation at follow-up, and (21) mental and physical development at follow-up. The information on the above items was insufficient in some cases which were omitted from the analysis making the number of cases in some of the tables different.…”

Section: Methodsmentioning

confidence: 99%

Infantile spasms: Etiological factors, clinical aspects, and long term prognosis in 200 cases

et al. 1981

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Abstract. The etiological factors, clinical aspects and long term prognosis were studied in 200 patients with infantile spasms. Forty-eight (24.0%) died and the rest were aged 6 years or more at the time of final follow-up. In 73 (36.5%) the etiology was prenatal, in 44 (22.0%) perinatal, and in 17 (8.5%) postnatal: 18 cases (9.0%) were cryptogenic. The remaining 4.8 (24.0%) patients were doubtful cases. The mortalily of the pre-and perinatal cases at 35.6% and 34.1% respectively was significantly higher than that in the other etiologic groups (P< 0.001).With regard to the onset of spasms, these were very early in the pre-and perinatal groups, whereas in the postnatal group the onset was late. The onset in the doubtful and cryptogenic groups was in between. Some 44.4% of the cryptogenic cases showed normal mental and physical development after the age of 6 years, whereas less than 10% of the prenatal and perinatal group did so, Almost all of the doubtful cases became mentally subnormal.The incidence of a family history of epilepsy or other convulsive disorders in the first, second and third degree relatives was highest in the cryptogenic cases (40.0%), and lowest in the perinatal cases (9.3%) (P<0.01). The incidence of laughing attacks was highest in the postnatal cases (42.9%), against no such attacks in cryptogenic cases (P<0.01). The attacks seemed to be linked with organic brain lesions. Among various factors related to the etiology of infantile spasms, genetic propensity seemed especially important in cryptogenic cases.

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“…Seizure semiology usually evolves into focal motor features, autonomic phenomena, and/or secondary generalization. 8,41,55) Some seizure types and EEG abnormalities are suggestive of epileptogenic foci in the temporal or frontal lobe. 12,40,41) Later on, seizures may become generalized and of multiple types, e.g.…”

Section: Etiologymentioning

confidence: 99%

Hypothalamic Hamartoma

Arita

Kurisu

Kiura

et al. 2005

Neurol. Med. Chir.(Tokyo)

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The incidence of hypothalamic hamartomas (HHs) has increased since the introduction of magnetic resonance (MR) imaging. The etiology of this anomaly and the pathogenesis of its peculiar symptoms remain unclear, but recent electrophysiological, neuroimaging, and clinical studies have yielded important data. Categorizing HHs by the degree of hypothalamic involvement has contributed to the accurate prediction of their prognosis and to improved treatment strategies. Rather than undergoing corticectomy, HH patients with medically intractable seizures are now treated with surgery that targets the HH per se, e.g. HH removal, disconnection from the hypothalamus, stereotactic irradiation, and radiofrequency lesioning. Although surgical intervention carries risks, total eradication or disconnection of the lesion leads to cessation or reduction of seizures and improves the cognitive and behavioral status of these patients. Precocious puberty in HH patients is safely controlled by long-acting gonadotropin-releasing hormone agonists. The accumulation of knowledge regarding the pathogenesis of symptoms and the development of safe, effective treatment modalities may lead to earlier intervention in young HH patients and prevent the decline in their cognitive abilities and quality of life. This review of hypothalamic hamartomas presents current classifications, pathophysiologies, and treatment modalities.

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Gelastic Epilepsy A Review and Report of Five Cases

Cited by 67 publications

References 12 publications

Pathological laughter in a patient with trigeminal neurinoma

Pathological laughter in a patient with trigeminal neurinoma

Infantile spasms: Etiological factors, clinical aspects, and long term prognosis in 200 cases

Hypothalamic Hamartoma

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