Dreyer R, Wehmeyer W
Fortschr Neurol Psychiatr Grenzgeb. 1978 Feb;46(2):61-75.
According to videotape analysis, laughter is a frequent (42.7%) symptom during psychomotor attacks. The results of our investigations show that it is no longer possible to regard it as a "curiosity", as did Janz (1969). It is an epileptic phenomenon like others and a symptom of automatism. It can occur in all phases of an attack. It is not remembered by the patient. We have been unable to establish any connection with age or sex. The form of expression is usually natural but inadequate and no affective motivation has been established. Laughter during an epileptic attack is an inborn emotional expression, structurally triggered by the involvement of the area around the hypothalamus-thalamic nucleus with the process causing the epilepsy. It is not actively experienced and is therefore not conscious and not an expression of the pleasant side of the affective complex moderated by the limbic system. The EEG's showed the usual variations occurring in psychomotor epilepsy. The temporal lobes are particularly involved. There is no "EEG Laughter Pattern". The group of patients considered here consist of severe, therapy-resistent cases of partial seizure epilepsy with pronounced cerebral lesions. In order to determine whether laughter is so common in less severe cases, a comparison group must be investigated. Laughter as a symptom of an epileptic attack is unknown to doctors and nursing staff and thus is either not recorded at all or, only very seldom. "Gelastic epilepsy" so-called does not exist as a nosology entity. This term should thus only be used--if at all--in cases where the laughter, together with a change in the level of consciousness, has over a period of years constantly been the only symptom of an attack, expecially when these attacks first became manifest in earliest childhood and are due to connatal changes in the hypothalamus-thalamic region.
根据录像带分析，笑是精神运动性发作期间的常见症状（42.7%）。我们的调查结果表明，不能再像扬茨（1969年）那样将其视为一种“奇闻”。它与其他症状一样是一种癫痫现象，是自动症的一种症状。它可出现在发作的各个阶段。患者对发作过程没有记忆。我们尚未发现其与年龄或性别有任何关联。其表现形式通常自然但不充分，且未发现有情感动机。癫痫发作时的笑是一种与生俱来的情感表达，在下丘脑 - 丘脑核周围区域参与导致癫痫发作的过程时，在结构上被触发。它并非主动体验到的，因此是无意识的，也不是由边缘系统调节的情感复合体中愉快一面的表达。脑电图显示出精神运动性癫痫中常见的变化。颞叶尤其受累。不存在“脑电图笑型”。这里所考虑的患者群体由部分性癫痫发作的严重、难治性病例组成，伴有明显的脑损伤。为了确定笑在不太严重的病例中是否也如此常见，必须对一个对照组进行调查。作为癫痫发作症状的笑，医生和护理人员并不了解，因此要么根本未记录，要么记录得极少。所谓的“痴笑性癫痫”并非一种疾病分类实体。因此，这个术语（如果非要使用的话）仅应在以下情况中使用：笑与意识水平改变一起，在数年时间里一直是发作的唯一症状，特别是当这些发作最早在幼儿期出现且是由于下丘脑 - 丘脑区域的先天性改变所致时。
