Gelastic seizures not associated with hypothalamic hamartoma: A long-term follow-up study

Giulia Iapadre, Luca Zagaroli, Nicola Cimini, Vincenzo Belcastro, Daniela Concolino, Giangennaro Coppola, Ennio Del Giudice, Giovanni Farello, Maria Laura Iezzi, Lucia Margari, Sara Matricardi, Alessandro Orsini, Pasquale Parisi, Marta Piccioli, Giulia Di Donato, Salvatore Savasta, Sabrina Siliquini, Alberto Spalice, Salvatore Striano, Pasquale StrianoAlberto Verrotti

Research output: Contribution to journalArticlepeer-review


Objective: The objective of the study was to describe the electroclinical features, seizure semiology, and the long-term evolution of gelastic seizures (GS) not associated with hypothalamic hamartoma (HH). Methods: We reviewed video-electroencephalogram (video-EEG) recordings from pediatric patients with GS without HH admitted to 14 Italian epilepsy centers from 1994 to 2013. We collected information about age at onset, seizures semiology, EEG and magnetic resonance imaging (MRI) findings, treatment, and clinical outcome in terms of seizure control after a long-term follow-up. Results: A total of 30 pediatric patients were stratified into two groups according to neuroimaging findings: group 1 including 19 children (63.3%) with unremarkable neuroimaging and group 2 including 11 children with structural brain abnormalities (36.7%). At the follow-up, patients of group 1 showed better clinical outcome both in terms of seizure control and use of AED polytherapy. Our patients showed remarkable clinical heterogeneity, including seizure semiology and epilepsy severity. Electroencephalogram recordings showed abnormalities mainly in the frontal, temporal, and frontotemporal regions without relevant differences between the two groups. Overall, carbamazepine showed good efficacy to control GS. Conclusions: Patients with nonlesional GS have a more favorable outcome with better drug response, less need of polytherapy, and good long-term prognosis, both in terms of seizure control and EEG findings.

Original languageEnglish
Article number106578
JournalEpilepsy and Behavior
Publication statusAccepted/In press - Jan 1 2019


  • Antiepileptic therapy
  • Carbamazepine
  • Dacrystic seizures
  • Gelastic seizures
  • Neuroimaging

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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