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A 2 year old male child presented with recurrent episodes of seizures in the form of behavioral arrest followed by abnormal laughter. He had about 2 - 3 episodes / day, refractile to medical management with sodium valproate.

There was no H/o GTCS, weakness of limbs, headache or vomitings. Systemic examination was otherwise WNL. Routine Blood investigations were WNL. EEG was suggestive of a Seizure disorder.

MRI Brain showed a single well-defined isodense lesion projecting from the left side of the Hypothalamus into the 3rd ventricle, with no evidence of ventriculomegaly or mass effect.

As the child was refractile to medical management, he had to undergo Rt. frontal craniotomy by transcallosal aproach & near total excision of the tumour.

Gelastic epilepsy is characterised by episodes of loud hollow, mirthless, stereotyped forced laughter.

Hypothalmic Hamartomas are the most common cause. Lesions involving ventro-medial nucleus of Hypothalamus may also cause Hyperphagia & obesity.

Gelastic seizures have also been described with cortical dysplasia in the cingulate Gyrus. A male predominance is noted and most of them show a good outcome after partial resection of the hamartoma.