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Gelastic Seizures – Hypothalamic Hamartoma — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersGelastic Seizures – Hypothalamic HamartomaSCE Neurology

A 50-year-old man presents with episodic uncontrollable laughter (gelastic seizures) followed by impaired awareness. MRI brain shows a hypothalamic hamartoma. What is the association between gelastic seizures and hypothalamic hamartoma?

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Correct answer: C — Hypothalamic hamartomas are the most common cause of gelastic seizures — they contain intrinsic epileptogenic neurons

Gelastic seizures (episodes of pathological laughter without mirth) are strongly associated with hypothalamic hamartomas. The hamartoma contains intrinsic epileptogenic neurons that generate seizures independently. These seizures are typically drug-resistant. Treatment options include thermocoagulation, stereotactic radiofrequency ablation, Gamma Knife radiosurgery, or surgical resection. Gelastic seizures may be the only seizure type initially, but secondary generalisation and other seizure types often develop. A: The association is well-established. C: Gelastic seizures are epileptic. D: They arise from the hypothalamic hamartoma. E: They frequently cause seizures.

Reference: NICE NG217; ILAE Seizure Classification; Berkovic et al. Gelastic Seizures