Gelastic Or Laughing Seizures are Visiting us today

Well, not good news today. I have called the neuro several times telling them the Lamictal is not working for Matthew's Myoclonic siezures. So far we have not changed meds, but we have upped the dosage. I have just been feeling that something is going to happen but not sure what because Matthew has not been acting right.

Well, Yesterday Matthew started having "Laughing Siezures". You may say that sound wierd or crazy but it's true. There are such seizures. Matthew can be just sitting or standing and all of a sudden, he'll started laughing like he was being tickled. Not just a "ha, ha" laugh but I mean a real gut wrenching laugh. It's cute if you don't know what you are looking at. He tolerated the first few because he wasn't sure what was going on. After the fourth or fifth one he would whine and cry (no tears) in between. He gets very irratable. You can't talk to him or soothe him. Only way to calm him is to get in the whirlpool. Even swinging on the front porch didn't help.

He probably had about 30 throughout the day yesterday before the neuro called and said to give him his bedtime pill, kolonopin, now. It was about 5:00 pm. He went to bed shortly thereafter and slept all night. Today he did much better. Only about five of the laughing seizures but the myoclonic jerks were really bad after he woke of from his naps. Still waiting to hear from his neuro to see if we are going to change medicines or up the dosage on the Lamictal.
Right now he's asleep and doing okay. Myoclonics jerks is the hardest type of seizure to get under control. They say the laughing siezure accompany myoclonics in most cases but this is the first time we've seen them since he started having the myo's about six months ago. We did see him have one in the hosptial when he was two years old but it was only one laugh, then a big seizure.

The neuro told us when matthew was born to expect seizures. Different types of seizures as he got older. So far he's been right. Matthew's little brain is trying it's best to be normal and happy and do things and learn but the bad part of his brain is misfiring onto the good part and causing these seizures. That's the only way I can explain it. As we get older and learn more, different parts of our brain starts transmitting neurotransmitters and that's what's happening with Matthew. The only way to keep him from having the siezure is to sedate him or find a good seizure med that will slow down the neurotransmitters in the area of the brain that is doing the misfiring. In the laughing siezures, it's the part of the brain that controls the hypothalamus.

I'm not real worried right now but if I don't see some progress soon, I may change my mind. Most kids like Matthew have a very grim prognosis and usually get too weak to fight off infections like pneumonia but I know that as long as I am around, I'll be there to keep him active and pneumonia is the least of our worries. My worry is that his brain is so malformed that the doctors may never be able to control all of his seizures. That would mean being almost totally sedated if they get to that point. So far God has helped Matthew make it this far and we'll just have to keep on praying because I know Matthew's work is not done here on earth yet. There are still to many people that have not opened their eyes and "saw the light" and too many that have not totally excepted him the way he is. And I'm not ready to give him back yet because I need more teaching from him on life, patients, caring and unconditional love. Keep him in your prayers.
Here is some information on the siezures. Did you know there are all different kinds of seizures?
It just depends where the misfiring in the brain is happeneing. Here are some examples. (Imagine these in a more exaggerated state, not the normal yawning, hiccupping, etc)
Yawning, hiccupping , eye twitiching, outbursts, leg tremors, arms, fingers and of course laughing.


HISTORICAL NOTE AND NOMENCLATUREDaly and Mulder coined the term "gelastic epilepsy" from the Greek word gelos, laughter, to emphasize the main character of these seizures (Daly and Mulder 1957). The possibility of sudden emotions as a manifestation of an epileptic seizure had been recognized since the end of the 19th century. These emotions were usually characterized as unpleasant; emotions of fear were most often described. Laughing seizures were first described by Trousseau (Trousseau 1877). Gowers observed emotions "with a cheerful character" as part of a seizure (Gowers 1881). Since then, ictal laughing or gelastic seizures has been described in different epileptic conditions associated with the temporal or frontal lobes. Gelastic seizures have been described most often in association with hypothalamic hamartomas. Gascon and Lombroso suggested the following criteria for the diagnosis of gelastic epilepsy: stereotyped recurrence; absence of external precipitants; concomitance of other manifestations generally accepted as epileptic; presence of interictal or interictal EEG epileptiform discharges; and absence of conditions in which pathological laughter might occur (Gascon and Lombroso 1971). Some patients have experienced both gelastic and crying seizures, termed "dacrystic" or "quiritarian" seizures (Sethi and Rao 1976).CLINICAL MANIFESTATIONS The clinical manifestations of gelastic seizures depend on the associated pathology. Laughter is usually a short manifestation (about 30s), particularly when it occurs as an isolated event. Although inappropriate, it can be so similar to the patients natural laughter that it can go without diagnosis for a long period of time. It has been recognized as part of a manifestation of several kinds of seizures such as partial seizures with motor symptoms, myoclonic seizures, axial tonic seizures, flexor spasms, generalized convulsive seizures, and petit mal absences (Loiseau et al 1971). The laughter is often prolonged if it is part of a more complex seizure disorder; occasional cases of gelastic status epilepticus have also been reported (Glassman et al 1986). The laughing component of the seizure can be differentiated regarding possible manifestations of mirth during the seizure (or sorrow during a crying seizure) as well as the affected level of consciousness. Such manifestations seem to be more commonly associated with focalities other than hypothalamic hamartoma (mirth generated from a temporal focus). Uncomplicated gelastic seizures generated from hypothalamic hamartoma, however, usually neither show components of mirth or altered level of consciousness (Arroyo et al 1993). Age of onset of gelastic seizures also varies depending on the associated pathology. If related to hypothalamic hamartoma, the main distribution seems to be from neonate 5 years, and the gelastic manifestations start before other later appearing seizure types. If associated with frontal lobe or temporal lobe seizures, onset is usually above the age of 5 years; gelastic seizures usually start in connection to or later than other seizure types. Gelastic seizures associated with hypothalamic hamartoma often appear several times daily or even hourly. This differs from the less frequently appearing gelastic seizures associated with other localizations. Although occurring frequently, gelastic seizures with hypothalamic hamartoma appear benign in infancy . Subsequently, during school-age years, the seizures usually become more complicated, other seizure types develop, and cognitive deterioration occurs. Severe behavior problems are common, and the seizures are usually intractable (Berkovic et al 1988; Valdueza et al 1994; Sturm et al 2000).
LOCALIZATION It has been suggested that normal laughter is the result of an interaction of several different brain structures: the frontal and temporal neocortex; the temporo-basal cortex; the visual, olfactorial, and auditorial associative areas; the limbic system with the cingulate gyrus; and the brainstem. The motor manifestations of laughter and the feeling of amusement or mirth have been claimed to be separable functions and, consequently, neurologically dissociated (Lopes da Silva et al 1990; Arroyo et al 1993). Gelastic seizures have been observed to be associated with many different conditions: mainly hypothalamic hamartomas, but also as a seizure manifestation in connection with temporal and frontal lobe lesions as well as other focalities. Hypothalamic hamartoma. Non-neoplastic malformations resembling gray matter. Temporal lobe lesions