• Tomoaki Fujita, Shinjitsu Nishimura, Hiroyuki Sakata, Yuichi Furuno, Masaki Mino, Emiko Hori, Mitsuomi Kaimori, Reizou Shirane, and Michiharu Nishijima.
• Department of Neurosurgery, Aomori Prefectural Central Hospital, Japan.
• No Shinkei Geka. 2009 Aug 1; 37 (8): 781-5.

AbstractGelastic seizure is a rare form of epilepsy defined as automatic bouts of laughter without mirth commonly associated with a hypothalamic hamartoma. Surgical treatment of hypothalamic hamartomas is associated with a high risk of complications because of the close vicinity of adjacent structures such as the optic tracts and mammillary bodies. This case was an 11-year-old girl who presented with gelastic seizure and complicated partial seizure. She developed gelastic seizure at a frequency of 10 bouts per day. She was found to have an elliptical mass close to the left hypothalamus. The signal intensity on magnetic resonance imaging (MRI) was consistent with hypothalamic hamartoma. The patient underwent surgical resection by a subtemporal approach. Pathological findings confirmed the diagnosis of hypothalamic hamartoma. Postoperative MRI demonstrated that the hypothalamic hamartoma was successfully resected. Twenty four months after surgery, complicated partial seizure in this patient has improved to Engel's class 1a and gelastic seizure has improved to Engel's class IIIa.

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