To take laughing toddler to A&E?

[Hogi]

I actually don't know if I'm being unreasonable here. I guess i'm just worried.

I can't remember when it started but my toddler would have random burst of uncontrollable laughter a few times a day for seemly no reason. Nothing was funny and it usually gets a bit worse when he's going to sleep or waking up but we just thought it was a quirk of his because he does have a genetic condition and probably is on the spectrum so we just kind of ignored it because laughing can't be bad?

Over the last 24 hours it's been relentless, it's happening more than it ever has and it kept him awake - it was short bursts of laughter for over an hour and he was getting really agitated.

I googled it and it's saying it maybe something called gelastic seizures - it's rare (but so is he's genetic condition) and the history and his symptoms seem to fit what's happening.

He's again having a few attacks this morning and obviously the doctors aren't open but I'm thinking if a 2 year old is potentially having seizures then maybe we should get him checked out?

I don't know really I don't think he can wait a few days with this going on as it's really affecting him (more than it usually does).

@carriebradshawwithlessshoes One way was whether it was appropriate. If we were trying to make him laugh then we knew he was happy. If the laughter was manic and included tears, we knew it was a seizure. We have strategies to try and break it. For us, it’s removing all sensory input. We use dark sunglasses, ear defenders and rigid arm gaiters (he puts his hands in his mouth), when it’s clear he’s on the cusp.

We also had a great paediatrician, so she was happy for us to set the parameters before rescue meds. We only use them after 30 minutes.

Doctors hate gelastics because they don’t know enough about them. It was thought you could only have them if you had a hypothalamic hamartoma. However, that’s not true.

Thank you. It’s tricky because a lot of what our DC do isn’t appropriate, so arguably walking around Tesco being incredibly giddy and laughing isn’t appropriate in any circs iyswim. But when he’s looking at me and almost ramping up as I’m telling him to stop, or making perfect eye contact with the lady on the till and laughing his head off, who knows???? Just very hard. Impossible even i would say to know if that’s some kind of brain misfiring or just a behavioural thing. I often wish I could carry an eeg machine in my bag to clamp on at certain times but obviously not!!

I assume he’s on meds. Do they not fully work?

DD used to have gelastic seizures. We could tell, because she was laughing for no reason. They could last upto 20 minutes.

I asked the epilepsy nurse about emergency medication and was told she didn’t need it for gelastic seizures.

In her case, she is always on 3 - 4 drugs; and gelastic seizures only happened when she was on zonisamide, plus others. We find quite a few drugs, in combination cause a new type of seizure - so on lamotrogine, she had tonic drop attacks. They stopped 10 days after she came off it. Lacosamide causes tonic seizures. We’ve been told, she is suffering toxicity.

Look up focal affect seizures - these are seizures, which produce an emotion. Gelastic are one type; there can be another type of focal affect seizures, which produce anger!

For us, nothing is totally controlled, unfortunately. He has many types of seizures and is on 3 anti-epileptic drugs.

You are right of course, every day they do something others would consider inappropriate. I would say, after these episodes he generally sleeps whereas he wouldn’t normally. Also, we’ve been living with it for 20 years so may be used to it.

ILAE call them emotional seizures:

https://www.epilepsydiagnosis.org/seizure/emotional-overview.html#:~:text=Focal%20emotional%20seizure%20with%20fear,anticipatory%20anxiety%20about%20having%20seizures.

If they can pinpoint where the seizures are coming from, they may be able to take out that bit of brain. Obviously there are bits of the brain that can’t be taken out. It’s not for the faint hearted as the risks are drummed into you, and electrodes can be put into the brain to identify the origin, which had risks in itself. There is some new laser surgery stuff which could help, with minimal invasiveness, that maybe suitable for those with very small lesions.

@Hogi
How is your little one doing? Thinking of you.

I know this is an old thread but I came across it after googling because my dd is the same with the laughing, it’s actually scary. Did you get any definitive diagnosis @Hogi in the end?

@Duckingfun I’m not the OP but am happy to help with info regarding gelastic seizures (laughter episodes). My son was diagnosed with them many years ago.

@Duckingfun nothing was found in my son. His EEG and MRI was completely clear so it's unknown what is the cause of his episodes.

They've decreased a lot and haven't been as bad as they were when I started this thread.

Hope you get some answers for your little one.

Thank you, it’s often at night, she’ll be staring at the wall laughing, it’s really, really creepy to be honest! She’s had a brain mri at a few months old to check for something else so I assume it would have flagged up any other issues, unless it’s something that can develop?

@Duckingfun the thing about scans is that you really need a seizure to happen at the right time to catch them .Also some of our sons seizures are so deep within the brain that they don't always show on scans unbelievably. Also our sons seizures are most common when falling asleep or waking up.He has laughing ( gelastic ,) seizures and i know what you mean about them looking creepy. That sort of dreamy phase of sleep seems to lower the seizure threshold. Have you filmed them and kept a "seizure diary "? it would be helpful if you get a referral to a neurologist to have evidence to present.

I have a couple of recordings and I’ll keep a diary and try to video her more.
my son used to have vacant episodes and there was one time at school where I was called in and he was laughing maniacally and couldn’t stop, it was awful. I wish I’d had gone to the doctors more with him to try and get answers.

How old are DS and DD, are they verbal, can they communicate at all what they are feeling? Can you break DD away from it (‘come on let’s get a drink/ biscuit/ look at a book ‘ type thing?)

@Anewuser out of interest did they medicate him for these seizures if they were gelastic only in presentation? I note OPs drs did confirm on witnessing them first hand that they were seizures but obv then took the view not to medicate? I wonder if that’s the norm?

@carriebradshawwithlessshoes
Not sure who your question is aimed at ? If it was me then my son is 9 and non verbal . V complex needs and already highly medicated for seizures.

Thank you @flapjackfairy . Sorry , that question was to @Duckingfun where she refers to the same problem with her DD and then her son. I’m totally derailing @flapjackfairy but I write elsewhere on MN and am the only one on that thread with an older child who is NV. So they say they have limited advice re speech etc. Do you think DS may speak, do you use other comm forms with success? All stuck for us.

DS is 8, people often talk about ‘complex’ needs and I’m never quite sure what that means. DS had 3 seizures when v young, was put on a low dose of epilim and had no more but I was too scared to wean him off so have only just done so fully in this last month. He’s v v inattentive, no physical problems, bright in many ways but reluctant to show it, v flitty , shown no great ability to gel with any other comm form, gets v irritable and frustrated therefore. Is that ‘complex, I’m never sure!

@carriebradshawwithlessshoes
No our son won't develop any speech sadly. His brain damage is too great. He relies upon us for all his needs and so is at the far end of the scale of disability.
Having said that he does manage to convey his emotions and express happiness through limited body language and facial expression etc.And we certainly know if he is scared or unhappy ! I actually forget he is non verbal a lot of the time because we know him so well and we have a close bond with him despite all his difficulties and can read him like a book. And we think he understands a lot more than most people give him credit for.
We also have an older child with complex needs who has the development of a toddler but is 17 yrs old. He has developed language over time with lots of repetition and echoing back any attempts at making sounds at all when he first started to develop language. Much like you instinctively do with a baby. We also learnt basic makaton and have used PECS etc in tandem with school.
He now has a wide range of words and communicates v well albeit at the developmental stage of a much younger child. In fact he never stops talking so we have the two extremes ha ha.
How old is your child if you don't mind me asking. Please feel free to PM me if you want to chat anytime .

DS was non verbal and is now classed as communication difficulties (after being told he would never speak) he was discharged from salt at 7 yo. He would be doing something, stop, then carry on as if he’s never paused. I have a video of him saying happy birthday and he literally goes ‘happy bir…. 2 minute pause of me trying to get him to continue, completely zoned out and then …thday to you’ the maniacal laughter at school lasted an hour ish, no getting through to him at all, it was like he wasn’t even there mentally. I just held and rocked him and afterwards he sobbed and then slept.

DD is 2 in a couple of weeks, completely non verbal. Doesn’t respond to her name or anything on the best of days. Have slight concerns about schizophrenia although I hope that’s me being dramatic. She will face the corner of a wall and sounds like she’s summoning demons (deep throaty noises in a sort of rhythm) has these laughter episodes, bangs her head, babbles to herself in the middle of the night, gets really upset for no reason I can see - clean, dry, fed, pooped, no temp - so figure she might be in pain but it’s not a pain cry, hard to describe but I give her calpol and rub her back and she eventually dozes off. Other than lining and stacking the stones from the fireplace the only thing she does is draw which is always circles, pages and pages of circles, she’s obsessed and I’m not exaggerating. Went to nursery to have a look around and she got hold of a crayon and started drawing circles on the wall.

DS is nearly 14 and sounds very similar to your 17yo, lots of repetition and echoing and starting with sounds ‘ah ah ah Apple!’and now he never shuts up, repeats himself often, gets stuck in a loop ‘mum um um um um….’ Drives me CRACKERS sometimes bless him. Yes DS I know you think that it was a bot who shot you in fortnite, you’ve told me 372 times, I’m trying to pee in peace though so please go away 🙈

@Duckingfun
Ha ha yes v familiar. I have developed selective deafness over the years. My 17 is now shouting boing which is a sign of agitation and playing the same 2 second soundbite from an episode of Postman Pat for the millionth time today. ( Ready Ted ? Ready as I'll ever be ? Ready Ted ? Ready as I'll ever be .....over and over again ).
You have to have a sense of humour for sure!

Oh my goodness it’s amazing to know I’m not on my own! Ds can play a certain sound on repeat for hours and hours and I love that boy to bits but jeez it’s tough! These kids definitely teach patience!

@Duckingfun
You are definitely not alone ! I agree it is definitely character building ! x

@carriebradshawwithlessshoes he was already on epilim for tonic clonic seizures but introduced keppra for gelastics. It helped but has never completed controlled them. He still has them daily. They are sensory triggered but we have other coping mechanisms, like ear defenders and arm gaiters.