A detailed study of three patients with gelastic seizures and a review of the literature are presented. Hamartoma of the tuber cinereum was diagnosed in two cases, subependymoma of the floor of the third ventricle in the third patient. The mechanism of ictal laughter, clinical associations and prognosis for seizure control are discussed. The resolution of MR imaging provides a basis to correlate some of the clinical manifestations with the anatomical disposition of the lesions within the hypothalamus.
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