Small hypothalamic hamartomas and gelastic seizures

PURPOSE: To describe the clinical history of patients with gelastic seizures (GSs) related to small-size hypothalamic hamartomas (HHs), and to show some of these unusual seizures. MATERIAL AND METHODS: Patients with GSs and the MRI finding of HH < 1 cm diameter. Ictal EEG or video EEG are required. RESULTS: Three patients, among 6 with GSs and HH, had a small sessile HH. None of them had a history of precocious puberty, nor any relevant cognitive defects. All patients suffered from other seizure types, in addition to GSs. GSs were drug-resistant in all cases. CONCLUSION: since small, not easily recognizable HHs may be present in patients with GSs, a careful MRI study of the hypothalamic, infundibular and mammillary bodys areas is mandatory in these cases [published with videosequences].