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Ictal Laughter Associated with Paroxysmal Hypothalamopituitary Dysfunction
Author(s) -
Arroyo Santiago,
Santamaría Joan,
Sanmartí Francesc,
Lomeña Francisco,
Catafau Ana,
Casamitjana Roser,
Setoain Javier,
Tolosa Eduardo
Publication year - 1997
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1997.tb01085.x
Subject(s) - gelastic seizure , hypothalamic hamartoma , ictal , ictal interictal spect analysis by spm , precocious puberty , medicine , epilepsy , endocrinology , hormone , psychiatry
Summary:Purpose : Seizures with ictal laughter (also termed gelastic seizures) have been associated with hypothalamic hamartomas and precocious puberty. It is not known, however, where in the brain such seizures originate. We describe a child with gelastic seizures and a hypothalamic lesion (probably a hamartoma) in whom two dysfunctional phenomena were observed. Results : First, there was a hyperperfusion in the hypothalamopituitary areas shown by ictal [ 99m ]Tc hexamethyl‐propyleneamine oxime (HM‐PAO) single photon‐emission computed tomography (SPECT). Second, there was an ictal pulse of gonadotropins, 17β‐estradiol, and growth hormone well above the normal limits in one of the seizures. Conclusion : These findings suggest that gelastic seizures associated with hypothalamic hamartomas are generated in the hypothalamus or in its neighboring regions and that these seizures may cause paroxysmal dysfunction of the hypothalamo‐pitutary axis.