It is known as gel epilepsy convulsive pathology whose main symptom is the irrepressible and involuntary laughter of the sufferer. It is not a known disease, except now for those interested in the film Joker, released recently. In it, the argument plays with the possibility that the protagonist suffers it.
As such, Gel epilepsy has been diagnosed since 1957, when scientists Daly and Mulder published a research paper that describes it. The article appeared in the magazine Neurology and laid the groundwork for the description of the clinical picture.
The term ‘gelastic’ has its origin in a Greek word that we could translate as ‘laugh‘. Certainly, the symptom par excellence that distinguishes this epilepsy from others is the laughter that appears spontaneously, even in situations where it is not justified at all.
This uncontrollable and involuntary laugh does not follow from a joke or a situation that merits it. It's more, many patients remember the episode of laughter sadly, associating distant feelings with joy or pleasure.
This confirms that the pathology is uncomfortable and is not a mere laughing episode. Patients feel that what is happening is inappropriate, but suffer for not being able to set a limit. In addition, they find it impossible to prevent the onset of laughter.
Gel epilepsy is more common among men than among women. Even so, its incidence is very low, of approximately 0.2%; this means that every thousand people there can be two that have the pathology. It has its classic age of appearance between three and four years.
Causes of gel epilepsy
Gel epilepsy can be an atypical seizure that responds to genetic mechanisms or mechanisms of little-known neuronal connections. Anyway, there is a underlying cause that has been associated and it is the tumor of the hypothalamus.
Two types of tumors can develop in the hypothalamus: hamartomas and astrocytomas. Though these are tumors that tend to be benign, its slow growth, but sustained, presses structures generating different symptoms.
As benign tumors, both hamartomas and astrocytomas do not develop metastases. Nor do they invade neighboring organs to the hypothalamus.
A tumor in the brain can cause gel epilepsy
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Laughter of gel epilepsy poses a diagnostic challenge for doctors. This inappropriate and uncontrollable laughter is not necessarily always a form of seizure. It may also be due to other pathologies.
Before a drugged or alcoholized person, it is possible to find a laughter similar to that of gel epilepsy. Obviously, it is not a symptom that appears chronic, but it triggers with consumption. That is the key point to differentiate one entity from the other.
There is also a syndrome known as Angelman who has laughter as a symptom. It is a disabling genetic alteration. In Angelman syndrome there is a noticeable developmental delay. From the age of six months, parents may notice that their child has a problem with their nervous system.
Finally, the entity that causes most confusion is pseudobulbar paralysis. Possibly, the point of differentiation between it and gel epilepsy is that, in pseudobulbar paralysis, laughter appears in people who suffer from another underlying disorder, such as Parkinson's disease, for example.
Symptoms of gel epilepsy
We have already said it and we repeat it: the primary symptom of gel epilepsy is laughter. Now, it is not a laugh like any other, but it has special characteristics that make it unique and different.
Laughter of gel epilepsy lasts less than a minute and appears, as it disappears, suddenly. It is involuntary and the patient cannot decide to stop it because he has no control over it.
Next to laughter, sometimes, classic symptoms of seizures appear, such as movements through muscle spasms, momentary loss of consciousness and sphincter relaxation. These symptoms can last even when the laughter is over.
In children who start with laughter and develop signs of precocious puberty, a hamartoma is very likely growing in the hypothalamus Precocious puberty is understood as the appearance of signs of adolescence before the age of eight or nine.
The gel form is a variant of epilepsy and seizures and is treated as such.
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Gel epilepsy is treated with the same medications that are used for seizures. Among them, we can mention carbamazepine, lamotrigine, topiramate or levetiracetam, among others.
It is not easy to gain control of the symptom of laughter. Unfortunately, the treatment never becomes effective enough. Crises of laughter are repeated cyclically, deeply affecting the quality of life of patients.
Despite the difficulties involved, it is important to know that much progress has been made in the investigation of anti-epileptic drugs. In addition, today, many groups of professionals in the world are more trained in the disease and more trained to address it.