A seven-year-old girl with inappropriate laughter
A seven-year-old girl presents with a several-month history of difficulty in school secondary to multiple outbursts of laughter at inappropriate times, interrupting classroom work, and causing distress. Her past medical and surgical history are unremarkable. She was delivered as a full term child, with no family history of known neurological disorders. No recent trauma was reported.
As part of her evaluation, a brain MRI, with and without contrast is ordered, with a representative image presented here.
Coronal MRI with T1 weighted sequence and gadolinium administration demonstrating 1.5 cm hypothalamic hamartoma, with characteristic findings of hypothalamic location, lack of enhancement and identical imaging as adjacent brain tissue.
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