Extended episodes of hysterical laughter while sound asleep

Patient

Q: Why am I having extended episodes of hysterical laughter while sound asleep?

Symptoms:  In the past 4 years I have two reported episode of uncontrollable laughter when I was asleep that lasted at least 20 minutes each, To the point when I would apparently be curling up in the fetal position because I was laughing so hard. Like a whole body laugh. I had though up to this point that those were the only two instances but I was talking with my high school roommate and she said this would occur at least once a week for only 5 minute increments . I am a suffer of depression and anxiety and am now on medication for it, but this has occurred on and off of medication. I already have trouble with being tired all day, yet have a problem falling asleep at night but when I am asleep, nothing can wake me! Is there a cause for these symptoms?
Doctor

A:   Hello
Thanks for using "Ask The Doctor" for posting your query.
I have gone through the detail and there can be two possibilities.
1. Parasomnia
2. Seizure Disorder
Coming to the second possibility as it is easier to diagnose and treat. Manytimes seizures can present in such a manner and seizures many time occur only in night. This occurs due to excessive discharges from a single site of the brain. The person may laugh excessively and this is known as gelastic epilepsy. This can be diagnosed by getting a test called eeg done which records the electric waves on the surface of the brain. If it comes positive then it can be treated with medicines such as levetiracetam or valproate.
If it is negative then it could be a part of the sleep talking parasomnia and then it doesnt have any specific treatment. Reducing the stress with aerobic exercises and inculcating a hobby or spending good time with friends and staying away from stress (work plus family) can help in reducing them.
But it would be wise to get the EEG test done first.
Do meet your doctor and get the tests done.
Hope this helps,
Wish you a good health.

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