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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(12): 1204-1212
DOI: 10.1055/s-0042-1758755
Original Article

A clinical evaluation of gelastic and dacrystic seizures: a multicenter study

Uma avaliação clínica das crises gelásticas e dacrísticas: um estudo multicêntrico
Aylin Bican Demir 
1   Bursa Uludag University, Faculty of Medicine, Epilepsy Center, Department of Neurology, Bursa, Turkey.
,
Başak Yılmaz Öz 
2   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Epilepsy Center, Department of Neurology, Istanbul, Turkey.
,
Mustafa Onur Yıldız 
2   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Epilepsy Center, Department of Neurology, Istanbul, Turkey.
,
Bengi Gül Türk 
3   Dr Selahattin Cizrelioglu Cizre State Hospital, Department of Neurology, Hakkari, Turkey.
,
Taner Tanrıverdi 
4   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Epilepsy Center, Department of Neurosurgery, Istanbul, Turkey.
,
Ahmet Bekar 
5   Bursa Uludag University, Faculty of Medicine, Epilepsy Center, Department of Neurosurgery, Bursa, Turkey.
,
Naz Yeni 
2   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Epilepsy Center, Department of Neurology, Istanbul, Turkey.
,
İbrahim Bora 
1   Bursa Uludag University, Faculty of Medicine, Epilepsy Center, Department of Neurology, Bursa, Turkey.
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Abstract

Background Gelastic seizures are extremely rare, short-lasting, unprovoked, and uncontrollable laughing attacks. We conducted this retrospective evaluation to determine whether these symptoms, manifesting in different forms, such as cheerful laughter, laughing, smiling, and sobbing had any value in terms of etiology or localization.

Methods A total of 31 patients who exhibited bouts of laughing or crying and who were under follow-up between 2000 and 2019 at tertiary epilepsy centers were included in the study. Laughing seizures were divided into three groups in terms of semiology (i.e., laughter with mirth, laughter without mirth, and smile). Dacrystic seizures were accompanied by some gelastic seizures and were divided into two groups in terms of semiology (i.e., weeping loudly [motor and voice-sobbing] and crying).

Results Of the 27 patients with laughing seizures, 12 had seizures that manifested with smiling, 7 had seizures that manifested with laughing and mirth, and 8 had seizures that manifested with laughter without mirth. Dacrystic-gelastic seizures were observed in four patients, among whom 2 patients had crying and laughter without mirth and 2 patients had weeping loudly and laughter without mirth episodes.

Conclusion Gelastic and dacrystic seizures often suggest hypothalamic hamartomas, in the literature. This rare ictal behavior can originate from different cortical locations and lesions of a different nature. However, we found that gelastic seizures with smiling were a more homogenous group with regard to location in the temporal lobe, which we aimed to show by evaluating the patients included in this study.

Resumo

Antecedentes Crises gelásticas são ataques de riso extremamente raros, de curta duração, não provocados e incontroláveis. Realizamos esta avaliação retrospectiva para determinar se esses sintomas, manifestando-se de diferentes formas, como riso alegre, riso, sorriso e soluço, tinham algum valor em termos de etiologia ou localização.

Métodos Foram incluídos no estudo 31 pacientes que apresentavam crises de riso ou choro e que estavam em acompanhamento entre 2000 e 2019 em centros terciários de epilepsia. As crises de riso foram divididas em três grupos em termos de semiologia (ou seja, riso com alegria, riso sem alegria e sorriso). As crises dacrísticas foram acompanhadas por algumas crises gelásticas e foram divididas em dois grupos em termos de semiologia (ou seja, choro alto [motor e soluçar a voz] e choro).

Resultados Dos 27 pacientes com crises de riso, 12 tiveram crises que se manifestaram com sorriso, 7 tiveram crises que se manifestaram com riso e alegria e 8 tiveram crises que se manifestaram com riso sem alegria. Crises dácristico-gelásticas foram observadas em quatro pacientes, sendo 2 pacientes com choro e riso sem alegria e 2 pacientes com choro alto e riso sem alegria.

Conclusão Crises gelásticas e dacrísticas frequentemente sugerem hamartomas hipotalâmicos, na literatura. Este comportamento ictal raro pode ter origem em diferentes localizações corticais e lesões de natureza diversa. No entanto, verificamos que as crises gelásticas com sorriso foram um grupo mais homogêneo quanto à localização no lobo temporal, o que buscamos evidenciar avaliando os pacientes incluídos neste estudo.

Keywords

Epilepsies, Partial - Seizures - Crying

Palavras-chave

Epilepsias Parciais - Convulsões - Choro

Authors' Contributions

ABD, BYÖ, MOY, BGT, TT, AB, NY, IB:


ABD, NY, IB, TT, AB: design; ABD, NY: supervision; ABD, BYÖ, BGT, MOY: resources; ABD, BYÖ, MOY, BGT, TT, AB, NY, IB: materials; ABD, BYÖ, MOY, AB, NY: data collection and/or processing; SCG, AA: analysis and/or interpretation; ABD, BYÖ, NY: literature search; ABD, BYÖ, MOY, BGT, TT, AB, NY, IB: writing manuscript; ABD, BYÖ, MOY, BGT, TT, AB, NY, IB: critical review.




Publication History

Received: 11 January 2022

Accepted: 21 April 2022

Article published online:
29 December 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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