Presentation
- Gelastic seizure or laughing seizures are spells of unmotivated laughter. The patient has short interval episodes of involuntary laughter.
- These unprovoked, out of context episodes are perceived as bizarre by people around.
- There is no social context or external trigger for the laughter and happen with no related emotion such as joy or sadness.
- The patient may or may not remember the laughter spell. There may be post ictal confusion.
Etiology
- These seizures indicate presence of Hypothalamic Hamartomas most of the times.
- Some cases have been reported in literature with temporal lobe or frontal lobe as foci of pathology such as tumors, post infectious foci or malformations giving rise to gelastic seizure.
- These are non-cancerous, nonprogressive lesion lesions in hypothalamus and are essentially abnormal tissue development in foetus
Associated features
- Hypothalamic hamartomas may also be associated with developmental delays, aggression, precocious puberty etc.
- Many behavioural and psychiatric symptoms are relatively common such as oppositional defiant disorder, attention-deficit/hyperactivity disorder, conduct disorder, and mood disorder in patients with hypothalamic hamartomas.
D/D
A wider variety of conditions can produce involuntary laughter pseudobulbar effect, which can happen after injuries to brain, in multiple sclerosis or even dementia.
In our Materia Medica this will be addressed by changeability or even laughter alternating with sadness etc.
Agaricus muscaris
A remedy which closely resembles gelastic seizure in its pathogenesy. Below are the different symptoms from various sources mentioned to point towards the similarity between the disease and the drug.
Hering
- Gaping: followed each time by involuntary laughter; makes him giddy; and sneezing, with pain in maxillary joint; with stretching, most of arms; and shaking chill.
- During violent shaking chill, after undressing in evening, a peculiar inclination to laugh.
- Morose, self-willed, stubborn, slow in learning to walk; and talk; on trying to walk; stumbled singularly often.
The Encyclopaedia of Pure Materia Medica
- Several convulsions followed each other in quick succession, first in posterior part of the chest, then in the epigastrium, afterwards in the hypogastrium, especially on the right side, attended with a sensation as if the whole body was shaken through; in the evening when standing.
- Epilepsy. In patients with epilepsy the fits came on at short intervals.
- He yawned frequently and each yawn was followed by involuntary laughter. An impulse to laugh came over in bed, owing to an indiscernibly mixed sensation of happiness and misery.
Boericke
- Laughing involuntary from pressure of spine.
- Yawning followed by involuntary laughter.
D/D- In complete repertory many other medicines are given, such as- AGAR, BORAX, AURUM, CANN IN, IGNATIA, NAT MUR, PHOS, SEPIA, TARENTULA
In summary Gelastic seizures require careful evaluation for underlying neurological conditions like hypothalamic hamartomas. From a homeopathic standpoint, Agaricus Muscarius stands out as a close remedy due to its unique symptoms of involuntary laughter, convulsions, developmental and behavioural, and emotional disturbances aligning well with the clinical picture of gelastic seizure.
References
- The Guiding Symptoms of Our Materia Medica by Hering
- Boerick’s Materia Medica
- The Encyclopedia of Pure Materia Medica by T F Allen
- Complete Repertory
- www.medscape.com
- www.sciencedirect.com
- https://www.ncbi.nlm.nih.gov/books/NBK560663/
NB: This similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition in a patient.
This kind of approach is especially helpful when:
- The patient is not able to give refined symptoms and sensations
- One is not able to find any characteristic symptom or
- The attendants are not able to give one,
- There is time constraint or
- The physician has not seen the patient but has received a diagnosis from attendants.
- Pathology is advanced enough to wipe out the PQRS of the case.
The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.
(This post is for the practitioners of Homoeopathy and not for patients for diagnosis and treatment of the said entity.)
Aude Sapere
Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/