Gelastic epilepsy: what you need to know about ‘laughing seizures’

  • June 7, 2022
  • 3
In this article

Gelastic epilepsy is a very rare kind of epilepsy that makes people have laughing seizures. The seizures are caused by a sudden burst of electricity in the brain, and this makes people laugh uncontrollably for no apparent reason.

Because gelastic epilepsy is rare (less than one or two in 1000 children with epilepsy have it) it is not always easy to diagnose. 

So, what is a laughing seizure? Here is what you need to know about gelastic epilepsy.

What is a laughing seizure?

Gelastic epilepsy makes people laugh uncontrollably for anywhere between a few seconds and up to one minute. The laughter is often described as ‘hollow’ or ‘unnatural’, and it happens out of context (the person will not be laughing at something funny). The name comes from the ancient Greek word gelos, which means ‘laughter’.

It is slightly more common in boys than girls, and usually begins in childhood - although it can also develop later in life.

Gelastic seizure symptoms include:

  • Unprovoked laughter lasting for less than one minute. Sometimes the laughter presents as ‘cooing’, smiling, crying or heavy breathing.
  • Shortly after the laughing seizure, it’s common to have another kind of seizure, such as a tonic-clonic seizure.
  • It is also common for the individual to twitch, smack their lips or fidget after the laughing seizure.

What causes laughing seizures?

Gelastic epilepsy often begins in early childhood, and has long been associated with a certain kind of brain tumor called a hypothalamic hamartoma. This brain tumor is benign, which means it will not go on to affect other cells.

That said, there are several other causes of gelastic epilepsy, including lesions on the frontal and parietal lobes. One 2015 study of gelastic epilepsy in adults reported on an adult man whose laughing seizures began after having a parasitic infection.

Diagnosing gelastic epilepsy

Laughing seizures can sometimes be difficult to diagnose because the symptoms may look like a number of other childhood development issues. It can be useful to take a video of your child’s seizures, with audio, to show the doctor.

Gelastic epilepsy is usually diagnosed with an EEG. Electrodes are attached to the child’s scalp to monitor brain wave patterns. It is also common to use an MRI scan which might be able to spot a hypothalamic hamartoma.

Laughing seizure treatment

Between one third and 45% of people with gelastic seizures are able to control their epilepsy with medication. For most people it is ‘refractory’, and may not be possible to control for long periods of time.

Brain surgery can be an effective solution if the cause of the seizures is a tumor. Removing the tumor can, for some people, lead to seizure freedom.

Difficult outlook for gelastic epilepsy

Although some people with laughing seizures are able to control them, the condition is typically hard to manage and may come with other problems, including delayed development, emotional problems, and sometimes early onset puberty. It is very helpful to remain in close contact with your medical team and so you can stay up to date with all new treatment options as they become available. 

Related: Help for children with epilepsy

If you, or someone you know, have gelastic epilepsy, keep speaking with your doctor to learn about potential seizure treatment options and support. 

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