A 6-year-old boy presents with recurrent brief episodes of inappropriate laughter without obvious triggers. Physical examination reveals accelerated linear growth and premature pubic hair development. Vital signs show BP 118/76 mmHg, HR 92/min, RR 20/min, temperature 37.2°C, and SpO2 98% on room air. Brain MRI demonstrates a 1.2-cm midline mass near the tuber cinereum with T2 hyperintensity. Serum prolactin is elevated at 68 ng/mL. The child denies headaches. Which of the following is the most likely diagnosis?
- A)Infantile spasms
- B)Benign rolandic epilepsy
- C)Psychogenic nonepileptic seizure
- D)Absence seizure
- E)Gelastic seizure from hypothalamic hamartomaGABARITO
Explicação
Gelastic seizures consist of sudden stereotyped laughing spells and are classically caused by hypothalamic hamartoma. This lesion can also produce central precocious puberty because of hypothalamic dysregulation of gonadotropin release. Ver explicação completa e trilha adaptativa →