Gelastic crisis: causes, symptoms, diagnosis, treatment

Seizures are periods of abnormal electrical activity in your brain that can cause changes in your:

  • consciousness
  • behviour
  • feeling
  • Memory
  • physical movements

The most common cause of seizures is epilepsy, which affects approximately 3 million adults and 470,000 children in the United States. Epilepsy is characterized by recurring seizures not caused by an underlying medical condition, such as high fever or low blood sodium.

Gelastic seizures are a type of seizure nicknamed “laughing fits” because they are characterized by uncontrolled laughter or laughter. Read on to learn more about this rare type of seizure.

A gelastic seizure is a rare focal seizure that causes uncontrolled laughter or laughter even when there is no joy or happiness. A focal seizure is a seizure that begins in one part of your brain, as opposed to generalized seizures that develop throughout your brain.

On a third gelastic crises are associated with hypothalamic hamartoma, a non-cancerous tumor near your hypothalamus. Your hypothalamus is a part of your brain that has many essential functions like controlling hormones and temperature.

Another third are associated with lesions of the frontal or parietal lobes. Rarely, they can be caused by damage to other areas, including the occipital lobe.

Gelastic crises take their name from the Greek word “gelos”, for laughs.

Although gelastic seizures are not life-threatening, they often do not respond well to medication. They are associated with other health problems that can impact your or your child’s quality of life.

About 60 to 65 percent of people with these seizures have cognitive problems. They are also strongly associated with behavior problems such as mood disorders, anxiety or aggression.

About half of children who experience gelastic seizures go through precocious puberty due to excessive secretion of gonadotropin-releasing hormone and luteinizing hormone. Untreated precocious puberty often leads to short stature and emotional issues such as self-image issues, as well as other conditions.

Most people who experience gelastic seizures experience other types of seizures.

Gelastic crises are rare and probably to diagnose in children. Little is known about their frequency, especially in adults, but they tend to develop in early childhood.

Gelastic crises are often associated with hypothalamic hamartoma, which affects approximately 1 in 50,000 to 1 in 100,000 children and adolescents. Hypothalamic hamartomas are tumors present at birth. Thus, gelastic crises associated with hypothalamic hamartoma begin in early childhood.

When occurring due to damage in other areas of the brain, gelastic seizures can begin later in childhood or adulthood.

According to research that grouped people according to their assigned sex at birth, men are thought to develop hypothalamic hamartoma about 30% more often than women.

As far as researchers currently know, people of all ethnicities are at the same risk.

The main symptom of gelastic seizures is uncontrolled laughter that usually lasts 2 to 30 seconds. These bursts of laughter often have a high frequency and can occur dozens of times a day.

When a person having a gelastic crisis laughs, it often seems forced and unnatural. Laughter often occurs in the absence of joy or happiness and can occur in social situations where laughter may not be appropriate.

Other symptoms that may accompany laughter include:

Gelastic seizures are focal seizures, and abnormal electrical activity can quickly spread to other areas of the brain, causing other types of seizures.

Symptoms of Gelastic Crisis in Toddlers and Babies

It can be difficult to recognize gelastic fits in babies and young children, as the peals of laughter may not seem unusual.

Babies may growl or squirm in an unusual way when they have gelastic fits, and their laughter often stops suddenly. Children and babies may seem confused or tired after their seizure is over.

Although they seem happy, most people do not feel happy during gelastic crises. People usually remain conscious during the seizure and may feel scared or anxious. A person may also experience:

  • an aura before their seizure begins
  • up to dozens of seizures per day
  • automatic behaviors like lip smacking or swallowing
  • butterflies in the stomach or a strange feeling in the chest

Once the crisis is over, the laughter tends to stop abruptly. The person may be confused or sleepy, but they may also feel normal. Some people may have another type of seizure immediately after a gelastic seizure, such as an atonic seizure. convulsion or tonic-clonic seizure.

Most of the time, gelastic crises are associated with a non-cancerous mass present in the hypothalamus at birth, called a hypothalamic hamartoma. But they can also come from masses in your frontal or temporal lobes.

There are other causes. For example, a case study 2015 examined a man who developed gelastic seizures after a parasitic brain infection called neurocysticercosis.

Usually, no special action is needed if you or someone you are with is having a gelastic crisis. You can’t stop the seizure while it’s happening, so all you can do is stay calm and try to comfort the person.

It is important to see a doctor whenever you or your child has a seizure for the first time. A seizure can be caused by a variety of medical conditions and requires prompt diagnosis. Although gelastic seizures themselves usually do not require medical attention, they can occur with other types of seizures that can cause serious symptoms.

Medical emergency

You should call 911 or go to the nearest emergency room when:

  • a seizure lasts more than 3 minutes
  • the person does not wake up after their seizure
  • the person is pregnant
  • it is the first crisis of the person
  • they experience repeated seizures in a row

Gelastic seizures often do not respond to anti-epileptic drugs. Your doctor may recommend surgery if your or your child’s seizures are impacting their quality of life and they are not responding to medication. There is strong evidence that removing hypothalamic hamartoma can improve symptoms and behavioral issues.

Several surgical techniques can be performed, including:

An electroencephalogram (EEG) is the tool commonly used by doctors to diagnose gelastic seizures. An EEG measures your brain’s electrical activity and looks for unusual patterns.

EEGs often show normal or mildly unusual activity in people with gelastic seizures, especially when they don’t have a seizure.

An MRI can help doctors identify a hypothalamic hamartoma.

Gelastic seizures are characterized by uncontrolled laughter or giggling. These seizures are most often caused by non-cancerous masses in a part of your brain called the hypothalamus. Often they do not respond to anti-epileptic drugs, but surgical removal often alleviates symptoms.

If you think you or your child may be having gelastic seizures, it’s important to see a doctor for proper diagnosis and treatment.

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