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lauhing seizure while sleeping

Hi
My niece has developed a sleeping disorder of laughing seizure like she laughs while i sleep for 3-4 seconds and then stare and then sleep and this pattern at times is also during day time when she is awake.
We did EEG and MRI and nothing came out from them.Follwoing is the report of both.


EEG

It is a wake reord.patient was fairly cooperative.
Artifacts are minimal.
Photic stimulation from 3 hz to 21 hrtz was given for 45 seconds.At an interval of 5 secs inclose eye state.
Hyperventilationwas performed for 3 mintues
EEG shows nearcontinuous occipital alfa of approximately 7-9 hrtzand upto 20-50 microvolts which repsonds to eye opening.
At places slow wave activity seen.

No hard signs of epilepsy seen.
No evidence of focal lesion seen electroencaphalographically

MRI

Thickened gyrus is seen in right temporo parietal region-Pachgyria.A small rounded lesion showig signal intensities similar to grey matter is seen within the white matter in right temporo parietal region-Nodular grey matter hetrotopia.
Elsewhere both the cerberal hemisphere shows normal MR morphology,signal intensity and grey white matterdifferentiation.
No midline shift is scene
Both lateral ventricles and third ventricles are normal in size.
Fourth ventricle normal in size and midline in position.
Brain stem and cerebellar hemishperes are showing normal MR morphology and signal intensity
Basal cisterns are normal
Major arteries of cirlce of willies are shwoing normal flow void.
major intracranial dural venous sinuses are shown normal outline and flow void.
Sella is normal in size.Pituotary gland is visualized normally with both posteriar and anterior lobes showing normal signal inensity.

IMPRESSION
Thickened Gyrus-Pachygyria with nodular grey matter heterotopia in right temporo parietal region .
3 Responses
Avatar universal
MEDICAL PROFESSIONAL
Hi,

Do you live with your niece?I just have a few questions regarding her condition:

-How old is she when she started having the episodes?
-How old is she now?
-is there any history of seizure disorders or congenital anomalies in the family?
-are there any remarkable circumstances surrounding her birth i.e. premature rupture of membrane
-any recent infections,head injuries ?
-how is your niece's level of development? Are her motor and social skills at par with others of her age?
-any muscular spasms or loss of consciousness  associated with the episodes?

A laughing seizure appears to be a highly probable differential to consider for your niece's condition.Gelastic seizure as it is called medically is usually associated with anatomical abnormalities in the brain.This may be associated with some growths or neoplasms like hypothalamic hamartomas or migrational abnormalities( caused by abnormal cellular movement during embryonic development) like nodular heterotopias.Abnormalities in the  frontal and temporal lobes ( the brain is divided anatomically into lobes which perform specific functions) may be associated  with gelastic seizures.Pachygyria which is considered as a migrational abnormality of the brain refers to thickened convolutions of the brain's surface.Pachygyria is also associated with seizure disorders and other genetic anomalies.  These anatomical characteristics may be detected through an MRI. An impression of your niece's MRI mentioned both heterotopia and pachygyria.

Most EEG results for patients with gelastic seizures do not show any abnormalities.I suggest you consult a pediatric neurologist . A normal EEG may not entirely rule out a seizure.
Further functional tests might be requested for her condition.

Continue to reassure yor niece and watch out for any difficulty of breathing or loss of consciousness that might accompany the episodes.

I hope this helps.
Avatar universal
Hi
firstly accept my heartiest thanks for responding really appreciated.
My niece lives in India an diam stayng in USA.

The thinkg i would like ot mention is that she is being taken care of 24*7 like all her wish list and whatever she wants is fulfilled you can say sort of spoil child.

How old is she when she started having the episodes?
She started having these a week back.

-How old is she now?
She is 7 yrs old.

-is there any history of seizure disorders or congenital anomalies in the family?
No history on both sides.

-are there any remarkable circumstances surrounding her birth i.e. premature rupture of membrane
No remarkable circumstances surrounding her birth.

-any recent infections,head injuries ?
No recent finections n head injuries.

-how is your niece's level of development? Are her motor and social skills at par with others of her age?

Her social skills are at par with others of her age

-any muscular spasms or loss of consciousness  associated with the episodes?
No such spasms .We had  shown her to a neurologist an dhe has given her some medicine and ruled out any abnormalities.Please suggest.What is the impact of medicines on child's devlopment?
Avatar universal
MEDICAL PROFESSIONAL
Hi,

When you say medications are you referring to a specific type of drug?

Any form of drug therapy may have its own specific effects on the body.This varies with

-how the drug was administered ( oral, intravenous , intramuscular)

-how fast the drug is broken down by the body and which organs are directly involved (usually liver and kidneys)

-drug's ability to cross certain innate barriers within the body i.e. blood and brain barriers

-the drug's interaction with other medications

-the person's age, weight and degree of compliance

-length of time the drug was taken

The effect of medications on children may be affected on whether certain drugs have been taken by their mothers prior to birth. Some medications may lead to birth defects or what we call congenital anomalies when taken at a specific time of pregnancy( usually in the first 3 months). Medications  requiring chronic use ( ie.maintenance meds for seizures )   may have subtle effects on a child's behaviour and learning. Thus, children taking medications have to be supervised closely by their physicians for any need to withdraw or adjust the dose of the drug.

Just keep the positive attitude.Your niece needs that from you. I hope this information helps.

Keep me posted.


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