Skip to main content
SpringerLink
Log in

Gelastic seizures treated by resection of a hypothalamic hamartoma

  • Case Reports
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

A 7-year-old girl presented for evaluation of a peculiar kind of epilepsy. Her seizures began before 1 year of age and consisted of episodes of brief, uncontrolled and unprovoked laughter than with time progressed to include cursive, complex partial and generalized tonic-clonic seizures. Progressive impairment of cognitive functions was noted as well as precocious puberty. Neuroimaging examination disclosed a hypothalamic hamartoma. It was excised by a pterional approach, and no further seizures were noted. The authors propose direct surgery for the hypothalamic hamartoma as a treatment for this progressive syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alvarez-Garijo JA, Albiach VJ, Vila MM, Mulas R, Esquembre V (1983) Precocious puberty and hypothalamic hamartoma with total recovery after surgical treatment. Case report. J Neurosurg 58: 583–585

    Google Scholar 

  2. Bajorek JG, Lee RJ, Lomax P (1984) Neuropeptides: a role as endogenous mediators or modulators of epileptic phenomena. Ann Neurol 16 [Suppl]: S31-S38

    Google Scholar 

  3. Balagura S, Schulman K, Sobel EH (1979) Precocious puberty of cerebral origin. Surg Neurol 11: 315–326

    Google Scholar 

  4. Barral V, Brunelle F, Brauner R, Rappaport R, Lallemand D (1988) MRI of hypothalamic hamartomas in children. Pediatr Radiol 18: 449–452

    Google Scholar 

  5. Berkovic SF, Andermann F, Melanson D, Ethier RE, Feindel W, Gloor P (1988) Hypothalamic hamartomas and ictal laughter: evolution of a characteristic epileptic syndrome and diagnostic value of magnetic resonance imaging. Ann Neurol 23: 429–439

    Google Scholar 

  6. Breningstall GN (1985) Gelastic seizures, precocious puberty, and hypothalamic hamartoma. Neurology 35: 1180–1183

    Google Scholar 

  7. Culler FL, James HE, Simon ML, Jones KL (1985) Identification of gonadotropin-releasing hormone in neurons of a hypothalamic hamartoma in a boy with precocious puberty. Neurosurgery 17: 408–412

    Google Scholar 

  8. Curatolo P, Cusmai R, Finocchi G, Boscherini B (1984) Gelastic epilepsy and true precocious puberty due to hypothalamic hamartoma. Dev Med Child Neurol 26: 509–527

    Google Scholar 

  9. Druckman R, Chao D (1957) Laughter in epilepsy. Neurology 7: 26–36

    Google Scholar 

  10. Gascon GG, Lombroso CT (1971) Epileptic (gelastic) laughter. Epilepsia 12: 63–76

    Google Scholar 

  11. Hahn FJ, Leibrock LG, Huseman CA, Makos MM (1988) The MR appearance of hypothalamic hamartoma. Neuroradiology 30: 65–68

    Google Scholar 

  12. Han JS, Benson JE, Kaufman B, Rekate HL, Alfidi AJ, Huss RG, Sacco D, Yoon YS, Morrison SC (1985) MR imaging of pediatric cerebral abnormalities. J Comput Assist Tomogr 9: 103–114

    Google Scholar 

  13. Hibi I, Fujiwara K (1987) Precocious puberty of cerebral origin: a cooperative study in Japan. In: Kageyama N, Takakura K, Epstein F, Hoffman HJ, Schut L (eds) Intracranial tumours in infancy and childhood. Basic research, diagnosis and treatment. Karger, Basel, pp 224–238

    Google Scholar 

  14. Kammer KS, Perlman K, Humphreys RP, Howard NJ (1980) Clinical and surgical aspects of hypothalamic hamartoma associated with precocious puberty in a 15-month-old boy. Child's Brain 7: 150–157

    Google Scholar 

  15. Lin S-R, Bryson MM, Gobien RP, Fitz CR, Lee Y-Y (1978) Radiologic findings of hamartomas of the tuber cinereum and hypothalamus. Radiology 127: 697–703

    Google Scholar 

  16. List CF, Dowman CE, Bagchi BK, Bebin J 81958) Posterior hypothalamic hamartomas and gangliogliomas causing precocious puberty. Neurology 8: 164–174

  17. Loiseau P, Cohadon F, Cohadon S (1971) Gelastic epilepsy. A review and report of five cases. Epilepsia 12: 313–323

    Google Scholar 

  18. Matustik MC, Eisenberg HM, Meyer WJ III (1981) Gelastic (laughing) seizures and precocious puberty. Am J Dis Child 135: 837–838

    Google Scholar 

  19. Nishio S, Fujiwara S, Aiko Y, Takeshita I, Fukui M (1989) Hypothalamic hamartoma. Report of two cases. J Neurosurg 70: 640–645

    Google Scholar 

  20. Northfield DWC, Russell DS (1967) Pubertas praecox due to hypothalamic hamartoma: report of two cases surviving surgical removal of the tumour. J Neurol Neurosurg Psychiatry 30: 166–173

    Google Scholar 

  21. Pescovitz OH, Comite F, Hench K, Barnes K, McNemar A, Foster C, Kenigsberg D, Loriaux L, Cutler JB Jr (1986) The NIH experience with precocious puberty: diagnostic subgroups and response to short-term luteinizing hormone releasing hormone analogue therapy. J Pediatr 108: 47–54

    Google Scholar 

  22. Piccolo F, Conti S, Bozzao L, Bianco F, Galletti F, Giuffrè G, Pasquino AM, Finocchi G, Boscherini B (1982) Medical therapy of true precocious puberty due to hamartoma of the tuber cinereum. A report of 2 cases. Child's Brain 9: 232–238

    Google Scholar 

  23. Ponsot G, Diebler C, Plouin P, Nardou M, Dulac O, Chaussain IL, Arthuis M (1983) Hamartomes hypothalamiques et crises de rire. A propos de 7 observations. Arch Fr Pediatr 40: 757–761

    Google Scholar 

  24. Richter RB (1951) True hamartoma of the hypothalamus associated with pubertas praecox. J Neuropathol Exp Neurol 10: 368–383

    Google Scholar 

  25. Russell DS, Rubenstein LJ (1977) Pathology of tumours of the nervous system, 4th edn. Williams & Wilkins, Baltimore, pp 41–43

    Google Scholar 

  26. Sato M, Ushio Y, Arita N, Mogami H (1985) Hypothalamic hamartoma: report of two cases. Neurosurgery 16: 198–206

    Google Scholar 

  27. Takeuchi J, Handa H, Miki Y, Munemitsu H, Aso T (1979) Precocious puberty due to a hypothalamic hamartoma. Surg Neurol 11: 456–460

    Google Scholar 

  28. Zúñiga OF, Tanner SM, Wild WO, Mosier HD Jr (1983) Hamartoma of CNS associated with precocious puberty. Am J Dis Child 137: 127–133

    Google Scholar 

Download references

Author information

Author notes

  1. Helio R. Machado

    Present address: , Rua Rui Baroosa 1746, 140150, Ribeirao Preto, São Paulo, Brazil

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Ontario, Canada

    Helio R. Machado & Harold J. Hoffman

  2. Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Ontario, Canada

    Paul A. Hwang

  3. The University of Toronto, Toronto, Ontario, Canada

    Harold J. Hoffman

Authors
  1. Helio R. Machado
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harold J. Hoffman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul A. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Machado, H.R., Hoffman, H.J. & Hwang, P.A. Gelastic seizures treated by resection of a hypothalamic hamartoma. Child's Nerv Syst 7, 462–465 (1991). https://doi.org/10.1007/BF00263190

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00263190

Key words

Search

Navigation