Epileptic laughter with precocious puberty.

Williams, Melody; Schutt, W. H.; Savage, D. C. L.

doi:10.1136/adc.53.12.965

Cited by 21 publications

(4 citation statements)

References 5 publications

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“…The first description of crying seizures dates back to 1906 when Zilgien described “spasmodic crying” in a patient who finally died of luetic pachymeningitis (Zilgien 1906). Since then, the descriptions of paroxysmal and stereotyped crying were mostly limited to infrequent individual case reports and occasional descriptions of ictal crying in series of patients with other types of seizures (Breningstall 1985, Dreyer&Wehmeyer 1977, Kugoh, et al 1988, Kutlu, et al 2005, Oehl, et al 2010, Offen, et al 1976, Sethi&Rao 1976, Sher&Brown 1976, Williams, et al 1978). A pubmed search with the search terms ‘dacrystic’, ‘crying seizures’, ‘ictal lacrimation’, ‘ictal weeping’, ‘ictal tears’ and review of citation records showed that the number of patients available in literature since 1990 with dacrystic seizures and with information on at least one brain MRI is 22 (Table 4) (Arroyo, et al 1993, Dan&Boyd 1998, de Seze, et al 1995, Hogan&Rao 2006, Kahane, et al 1999, Kahane, et al 2003, Kahane, et al 1994, Lopez-Laso, et al 2007, Luciano, et al 1993, Procaccini, et al 2006, Tatum&Loddenkemper 2010, Wakai, et al 2002, Wang, et al 1995).…”

Section: Discussionmentioning

confidence: 99%

Dacrystic seizures: Demographic, semiologic, and etiologic insights from a multicenter study in long‐term video‐EEG monitoring units

et al. 2012

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and yyDepartment of Neurology, Osnabrü ck Clinic, Osnabrü ck, Germany SUMMARY Purpose: To provide an estimate of the frequency of dac-rystic seizures in video-electroencephalography (EEG) long-term monitoring units of tertiary referral epilepsy centers and to describe the clinical presentation of dacry-stic seizures in relationship to the underlying etiology. Methods: We screened clinical records and video-EEG reports for the diagnosis of dacrystic seizures of all patients admitted for video-EEG long-term monitoring at five epilepsy referral centers in the United States and Germany. Patients with a potential diagnosis of dacrystic seizures were identified, and their clinical charts and video-EEG recordings were reviewed. We included only patients with: (1) stereotyped lacrimation, sobbing, grimacing , yelling, or sad facial expression; (2) long-term video-EEG recordings (at least 12 h); and (3) at least one brain magnetic resonance imaging (MRI) study. Key Findings: Nine patients (four female) with dacrystic seizures were identified. Dacrystic seizures were identified in 0.06-0.53% of the patients admitted for long-term video-EEG monitoring depending on the specific center. Considering our study population as a whole, the frequency was 0.13%. The presence of dacrystic seizures without other accompanying clinical features was found in only one patient. Gelastic seizures accompanied dacrystic seizures in five cases, and a hypothalamic hamartoma was found in all of these five patients. The underlying etiology in the four patients with dacrystic seizures without gelas-tic seizures was left mesial temporal sclerosis (three patients) and a frontal glioblastoma (one patient). All patients had a difficult-to-control epilepsy as demonstrated by the following: (1) at least three different antiep-ileptic drugs were tried in each patient, (2) epilepsy was well controlled with antiepileptic drugs in only two patients, (3) six patients were considered for epilepsy surgery and three of them underwent a surgical/radiosurgical or radioablative procedure. Regarding outcome, antiepi-leptic drugs alone achieved seizure freedom in two patients and did not change seizure frequency in another patient. Radiosurgery led to moderately good seizure control in one patient and did not improve seizure control in another patient. Three patients were or are being considered for epilepsy surgery on last follow-up. One patient remains seizure free 3 years after epilepsy surgery. Significance: Dacrystic seizures are a rare but clinically relevant finding during video-EEG monitoring. Our data show that when the patient has dacrystic and gelastic seizures, the cause is a hypothalamic hamartoma. In contrast, when dacrystic seizures are not accompanied by gelastic seizures the underlying lesion is most commonly located in the temporal cortex.

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Section: Discussionmentioning

confidence: 99%

Dacrystic seizures: Demographic, semiologic, and etiologic insights from a multicenter study in long‐term video‐EEG monitoring units

et al. 2012

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“…Eine geIastische Epilepsie (Tab. I) kann bei einer Vielzahl von Erkrankungen des Temporallappens, des Hypothalamus oder des limbischen Systems auftreten (6,20,42,47); wir beschäftigen uns an dieser Stelle mit gelastischen Anfällen als Symptom der Hamartome des Hypothalamus.…”

Section: Gelastic Epilepsy and Precocious Puberty Due To Hypothalmic unclassified

Gelastische Epilepsie und Pubertas praecox bei Hamartom des Hypothalamus

et al. 1991

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Four cases of hypothalamic hamartoma leading to gelastic epilepsy, precocious puberty and behavioural disorders are reported. Cerebral neuroradiologic examinations revealed a tumor-like mass attached to the hypothalamus in the region of the mamillary bodies in all cases. Precocious puberty developed in the two girls at 4 and 13 months but in neither of the two boys, who both suffered behaviour disturbances in the form of aggressive outbursts. A total resection of the tumors of both boys led to histologic confirmation of hamartoma. One boy was free of seizures upon follow-up, whereas seizure frequency in the other boy was reduced, while his aggressivity increased. The cases are discussed in context of current therapeutic conceptions of gelastic epilepsy and central precocious puberty.

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“…Evidence that infantile seizures may also be associated with neuroendocrine problems is somewhat limited. Several authors have drawn attention to the incidence of precocious puberty and epilepsy (Elian, 1970;Konar & Basak, 1977;Penfold, Manson & Caldicott, 1978;Williams, Schitt & Savage, 1978). McGowan (1983) has reported that adult epileptics appear, in general, to be smaller than normal.…”

Section: Introductionmentioning

confidence: 99%

Seizure-induced delay of puberty in female rats: effects of age, stress and opioid antagonists

Carson

Wilkinson²

1989

Journal of Endocrinology

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We have shown that pre- and post-pubertal female rats are sensitive to seizures. For example, daily convulsions commencing at 24 days of age delay puberty. Here we examine the effect of seizures at various ages. In addition, because opioid peptides are implicated in regulating the onset of puberty and are activated by convulsions, we also investigate the effect of opioid antagonists in the seizure-induced delay of puberty. A single daily electroconvulsive shock (ECS) was given for 10 days to neonatal (days 2-11), infantile (days 15-24) and juvenile (days 22-31) rats. The treatment delayed vaginal opening (VO) in juvenile rats. Neonatal and infantile rats were unaffected. VO was also delayed by daily ECS for only 5 days in the late juvenile (days 27-31) period. The opioid receptor antagonists naloxone, naltrexone and nalmefene injected before and after single daily ECS were unable to block this effect of ECS on VO. To examine whether the effect of ECS is related to stress, we examined several stressors known to induce opioid-mediated alterations in gonadotrophin secretion. Footshock, immobilization and ether stress administered in the juvenile period (days 27-31) did not affect the timing of VO. In addition, rats anaesthetized with halothane, and then given ECS, still showed a delay of VO. These data demonstrate that rats in the late juvenile stage of development are most sensitive to convulsions. We also suggest that opioids are not critical to the mechanism by which the ECS disturbs puberty, and that ECS elicits its effect seemingly independently of the convulsive stress.

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Epileptic laughter with precocious puberty.

Cited by 21 publications

References 5 publications

Dacrystic seizures: Demographic, semiologic, and etiologic insights from a multicenter study in long‐term video‐EEG monitoring units

Dacrystic seizures: Demographic, semiologic, and etiologic insights from a multicenter study in long‐term video‐EEG monitoring units

Gelastische Epilepsie und Pubertas praecox bei Hamartom des Hypothalamus

Seizure-induced delay of puberty in female rats: effects of age, stress and opioid antagonists

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