Young girl’s uncontrollable laughter was actually a brain tumor


Scans of the girl’s brain. (Courtesy of José Liders Burgos Zuleta)
June 23

They say laughter is the best medicine. But what if laughter is the disease?

For a 6-year-old girl in Bolivia who suffered from uncontrollable and inappropriate bouts of giggles, laughter was a symptom of a serious brain problem. But doctors initially diagnosed the child with “misbehavior.”

“She was considered spoiled, crazy — even devil-possessed,” José Liders Burgos Zuleta of the Advanced Medical Image Centre in La Paz said in a statement. [14 Oddest Medical Cases]

But Burgos Zuleta discovered that the true cause of the girl’s laughing seizures, medically called gelastic seizures, was a brain tumor.

After the girl underwent a brain scan, the doctors discovered a hamartoma, a small, benign tumor that was pressing against her brain’s temporal lobe. Surgeons removed the tumor, the doctors said. She stopped having the uncontrollable attacks of laughter and now laughs only normally, they said.

Gelastic seizures are a relatively rare form of epilepsy, said Solomon Moshé, a pediatric neurologist at Albert Einstein College of Medicine in New York.

“It’s not necessarily ‘ha-ha-ha’ laughing,” Moshé said. “There’s no happiness in this. Some of the kids may be very scared,” he added.

The seizures are most often caused by tumors in the hypothalamus, although they can also come from tumors in other parts of brain, Moshé said. Although laughter is the main symptom, patients may also have outbursts of crying.

These tumors can cause growth abnormalities if they affect the pituitary gland, he said.

The surgery to remove such tumors used to be difficult and dangerous, but a new technique developed within the past 10 years allows doctors to remove them effectively without great risk, Moshé said.

The doctors who treated the girl said their report of her case could raise awareness of the strange condition, allowing doctors to diagnose the true cause of some children’s “behavioral” problems and refer them to a neurologist.

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