Uncontrollable laughter in a woman was discovered to be linked to a brain tumor, imaging showed.(Image credit: Jena Ardell via Getty Images)
The patient: A woman of 31 years
The symptoms: The woman sought medical help due to persistent episodes of unmanageable laughter, which doctors described as “joyless” in a report detailing her case. The patient reported experiencing these recurring bouts of involuntary laughter from her earliest years, yet her ailment had never undergone a formal evaluation or diagnosis.
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The woman mentioned that, during her youth, each instance would go on for several minutes and happened more often, roughly six or seven times each day, occasionally when she was asleep. The patient stated that her parents did not perceive the laughter as something she couldn’t manage. Instead, they believed her laughter was a choice and would ask that she stop. As she aged, the periods of laughter grew shorter and occurred less often.
What happened next: Before the patient’s consultation at the clinic, an MRI and electroencephalogram (EEG) scan of her brain did not reveal anything unusual. However, as the physicians looked at videos of her laughing fits, they realized they closely resembled gelastic seizures. This kind of seizure typically sparks out-of-control laughter, chuckling, or grinning, but it might also bring about groaning, muttering, or lip smacking. It gets its name from the Greek word for laughter (“gelastikos”).
Gelastic seizures usually arise from a localized origin, implying they stem from irregular electrical activity in one particular region of the brain. Using another MRI, the medical team spotted a region of irregularity inside the hypothalamus, a vital organ for maintaining balance in the body. The anomaly was about 0.2 inches (5 millimeters) in diameter.
The diagnosis: The doctors pinpointed the abnormality as a hypothalamic hamartoma, a non-cancerous mass that forms while the fetus develops. Gelastic seizures triggering episodes of uncontrollable laughter, during which the affected individual is aware yet without control over their actions, are a telltale sign of this growth. The precise explanation for why these lesions spark laughing spells remains unclear.
The treatment: The patient previously tried taking anti-seizure medications levetiracetam and lamotrigine, which are employed to treat epilepsy, but they had no effect. As her episodes weren’t considered severe, the woman opted out of medication.
She wasn’t dealing with any other cognitive or behavioral concerns, and the attacks had reduced in severity and frequency with the passage of time, so the medical professionals at the facility concluded that she required no further treatment.
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What makes the case unique: Hypothalamic hamartomas are uncommon, but when they occur, they typically coincide with mental and behavioral issues. In youngsters, these growths may lead to developmental lags or trigger the onset of puberty at an early age, because the hypothalamus is instrumental in controlling hormones. Individuals who experience gelastic seizures resulting from these lesions tend to develop more severe forms of epilepsy and undergo different seizure types later on.
The woman’s situation stands out significantly because her symptoms subsided naturally to a manageable degree. This favorable outcome of epilepsy associated with hypothalamic hamartomas “has not been reported before, to our knowledge,” the doctors stated.
For more captivating medical stories, have a look at our collection of Diagnostic Dilemmas.
Disclaimer
This piece serves solely as a source of information and should not be construed as dispensing medical advice.
TOPICSDiagnostic dilemma
Mindy WeisbergerSocial Links NavigationLive Science Contributor
Mindy Weisberger serves as a science reporter and author of “Rise of the Zombie Bugs: The Surprising Science of Parasitic Mind-Control” (Hopkins Press). She previously held an editing position with Scholastic and worked as a channel editor and experienced writer for Live Science. Her reporting spans across the field of general science, including topics such as climate change, paleontology, biology, and space. Mindy pursued film studies at Columbia University; before LS, she was involved in the production, authorship, and direction of media projects for the American Museum of Natural History in NYC. Her video presentations focusing on dinosaurs, astrophysics, biodiversity, and evolution are showcased in museums and science centers globally, garnering accolades like the CINE Golden Eagle and the Communicator Award of Excellence. Her written contributions have also appeared in publications such as Scientific American, The Washington Post, How It Works Magazine, and CNN.
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