Dr. Aida Abaz Quka
Neurology
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Patient's Query
Hello doctor,
An 18-year-old female lying in bed with no stimulus like TV and has a laughing fit. She cannot stop laughing, then could not breathe, so she had a panic attack and began crying. She has had similar situations about once per year for the last four to five years. Can this be a gelastic seizure? She is underinsured and would like to do nothing, but if it is likely something dangerous causing it she will have to see someone.
Medications: Depo shot q three months for birth control, Vyvanse (Lisdexamfetamine) for ADHD taken in the past sometimes prescribed as high as 90 mg per day. She is not taking now as she has graduated high school and does not think she needs it when not in school.
Hello,
Welcome to icliniq.com.
I would like to know if she has strange behavior during all the time, fluctuations in her mood, sometimes cries and sometimes feels euphoric? If she stays alone time after time feeling depressive and other times trying to attract the other's attention, being euphoric and impulsive?
In such a case, I would think about a psychiatric disorder. Otherwise, I would recommend performing an EEG (electroencephalogram) in order to exclude possible elastic seizures. A brain MRI (magnetic resonance imaging) would be necessary too.
I hope this helps.
Patient's Query
Thank you doctor,
Is it elastic seizures? EEG will not show a gelastic seizure unless it is happening right then, is it correct?
Hello,
Welcome back to icliniq.com.
I am sorry for the writing error, I meant gelastic seizures.
You should know that gelastic seizures usually have normal EEG in the early stages but later, the EEG shows many types of abnormalities, even in the absence of seizures during recording (interictal EEG).
Anyway, gelastic seizures are more common in children. They are related to brain malformations since birth, which can be detected in the brain MRI. That is why I recommended a brain MRI. On the other hand, seizures are not triggered by watching TV. Vyvanse can cause this clinical situation as a potential adverse effect. You should discuss with her doctor about the above issues.
I hope this helps.
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