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Gelastic seizures (GS) — also called gelastic epilepsy — are a rare type of epilepsy that involves a sudden burst of energy. These bursts usually appear as uncontrolled laughter followed by a state of confusion. (That’s why GS are also called “laughing” or “giggling seizures.”) Gelastic seizures are quite brief and most commonly seen in children.

What Are Gelastic Seizures?

Gelastic seizures are focal (partial) seizures that originate in the hypothalamus, frontal lobe, and temporal lobe of the brain. Focal seizures affect one area of the brain. However, they can sometimes become generalized seizures and affect the entire brain. If this happens, a person may also experience other types of seizures, too.

Gelastic seizures are very quick and last between five to 60 seconds. That said, they can reoccur many times throughout the day. People have reported experiencing anywhere from five to 100 seizures in one day.

People often describe having gelastic seizures as having the urge to laugh without having any reason, thought, or emotion. “It’s nothing like your normal laugh. It’s just a weird feeling,” shared a MyEpilepsyTeam member. Because of their unique characteristics, gelastic seizures tend to be unnoticed for years.

Gelastic seizures usually develop in early childhood, between the ages of 3 and 4 years old. Some adults may develop gelastic seizures, but it is quite rare. Less than 1 percent of adults living with epilepsy have gelastic seizures.

People in the midst of gelastic seizures are conscious, but some may have an altered state of awareness. “I had a gelastic seizure a few minutes ago,” shared one MyEpilespyTeam member. “It’s always a little weird — it will happen when I’m watching a movie or TV show. I randomly laugh, and have no memory of doing so.”

What Causes Gelastic Seizures?

The most common cause of gelastic seizures is a benign brain tumor that develops in early infancy called a hypothalamic hamartoma (HH). Signs of seizures typically begin in early childhood. If a person has an HH, they often develop other types of seizures over time. In addition, somewhere between 33 percent and 74 percent of those who get gelastic seizures that are caused by HH experience early puberty. (This is also called precocious puberty.) Scientists do not yet fully understand why this occurs.

Children with gelastic seizures and an HH typically have normal learning and communication skills before the onset of their seizures. One-third of children with an HH will go on to have learning disabilities, developmental delays, speech impairment, or below-average intelligence and communication skills. They may also develop behavioral problems, such as aggression, anxiety, and mood disorders (like depression).

Triggers and Risk Factors

Infants who develop a hypothalamic hamartoma have a higher risk of developing gelastic seizures. Having a maternal family history of migraines can also be a risk factor. Gelastic seizures can be triggered by emotions such as fear, anxiety, loud noises, or excitement, too. Generally, these seizures are a little more common in male children than in females.

Signs and Symptoms

The most common symptom of gelastic seizures is inappropriate and uncontrolled laughter. Those infants who exhibit an early onset of GS may have bursts of cooing, smiling, or increased breathing. Before having a seizure, a person with GS will have an aura (a warning feeling) and may be startled. They may look afraid or in a state of panic.

Other symptoms include:

• Laughing abruptly
• Grunting
• Smacking one’s lips
• Smiling that looks forced
• Mumbling
• Fidgeting

One study found that when compared to children with GS, adults with GS have less-severe symptoms and fewer learning or behavior difficulties. It is important to speak with a physician who specializes in neurology if you or your loved one develops any of these signs or symptoms above. Neurologists are experts in diseases of the brain and nervous system.

What To Do in the Event of a Gelastic Seizure

Gelastic seizures are sudden and last only a few seconds. When someone has a gelastic seizure, it is important to stay by them and offer support. Even if someone has a gelastic seizure with laughing, they can still be very uncomfortable, especially depending on their environment. If a seizing person was in public during an episode, they can get very anxious. And they might worry about what others think about their behavior.

It is important to educate others on what is taking place and do what you can to keep the person at ease and feel safe.

Medical attention is only needed if the individual injures themselves during the seizure, if they become unconscious after the seizure, or if the seizure lasts longer than usual.

How Are Gelastic Seizures Diagnosed?

Gelastic seizures can be diagnosed using a variety of methods. Since these seizures often emerge in childhood, pediatricians might refer parents or caretakers to a neurology specialist. The doctor will ask about the child’s overall health and family history. This helps them land on the underlying cause for symptoms. It can also unearth possible risk factors associated with the seizures.

Gelastic seizures are typically diagnosed with an electroencephalogram (EEG). This device measures someone’s brain activity with electrodes (small stickers that detect electric energy) applied to their scalp. A neurologist uses the electrode readings to understand the person’s brain waves. If any seizures happen while the electrodes are attached, the doctor can determine what kind they are. The doctor may also videotape the EEG. Having a visual of the seizure helps to match its timing to its related brain activity.

Neuroimaging tests such as MRI and CT scans can show pictures of different parts of the brain. These may also be used for locating potential brain tumors or lesions.

Treatment Options

Treatment plans are typically based on a person’s age, symptoms, and the type and severity of their seizures. There are many treatment options available today. Speak with your neurologist and health care team about the best options specifically for you or your loved one.

Anti-Epileptic Drugs

Anti-epileptic drugs (AEDs) can be effective in treating a variety of disorders by helping with seizure control. Gelastic seizures may be managed with:

• Carbatrol (carbamazepine)
• Keppra (levetiracetam)
• Lamictal (lamotrigine)
• Oxtellar XR (oxcarbazepine)
• Tegretol (carbamazepine)
• Topamax (topiramate)
• Vimpat (lacosamide)

Neurosurgery

If someone’s gelastic seizures are a result of a tumor, surgical treatment may be an option. Laser ablation is one option. In this procedure, light and heat from a laser kill unhealthy brain cells. A neurosurgeon uses imaging technology to place a probe in the right spot and then destroys the unhealthy brain cells with the laser. In some cases, radiation may also be used to shrink the tumor.

Talk With Others Who Understand

On MyEpilepsyTeam, the social network for people with epilepsy and their loved ones, more than 103,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Do you have or suspect you have gelastic seizures? Share your experience in the comments below, or start a conversation by posting on MyEpilepsyTeam.