Gelastic seizures and hypothalamic hamartoma: a case report and review of literature

Gelastic (laughing) epilepsy is characterized by recurrent unprovoked episodes of stereotyped, brief and mirthless laughter. Hypothalamic hamartoma is most often the cause of gelastic epilepsy. Hypothalamic gelastic epilepsy presenting as a progressive epileptic disease is well known, but isolated without multiple seizure types, precocious puberty, cognitive decline and behavioural problems is not usually reported. We report a case of refractory gelastic seizures associated with indolent hypothalamic hamartoma and polysyndactyly with a follow-up of 18 years. Our case highlights the possibility of underdiagnosed hypothalamic hamartomas and unrecognised gelastic epilepsy in paediatric population.