”The child does not know what strange disease, often non-stop laughing. Laughing, epilepsy three epilepsy, moving and fall down.” Lily’s parents said. In the past five months, Lily, 9 years old, often inexplicably laughing, laughing when the whole body weak, unstable, easy to fall, and sometimes jumping around, appearing unconscious, lasting about ten seconds, and then return to normal, 2-3 days a seizure. The parents took their child to seek medical help and finally found the cause at the epilepsy center – laughter epilepsy. Laughter epilepsy is a rare form of seizure, with only 100 cases reported in the domestic and international literature to date. The main manifestation of the disease is laughter, also known as demented laughter seizures, which often develop in childhood and can persist into young adulthood and adulthood. The number of seizures increases with the duration of the disease and may be accompanied by other types of epileptic seizures. It is often associated with hypothalamic malformation tumors. Children often have seizures without any trigger, with laughter as the main manifestation, with odd expressions, or silly smiles, or even bitter smiles, lasting 5 to 60 seconds; the seizures are mostly unconscious, with or without other types of epileptic seizures, and the child often cannot remember what happened at the time of the seizure. The laughing phenomenon can be seen in certain brain diseases and in the course of epilepsy. In severe cases, the child can have more than a dozen seizures a day, adding up to more than 8 hours of laughter per day. The initial stage of laughter seizures is often not taken seriously, thus often causing delays in treatment. Children should seek medical attention if they normally show some unusual behavior to minimize the damage. Many children with epilepsy have not fully developed brains and lesions are not obvious in places, so they cannot be treated surgically and can only be controlled with medication. Laughter epilepsy is a special type of epilepsy where antiepileptic drug therapy is less effective. Generally, carbamazepine can be preferred, and drugs such as valproic acid can also be used to minimize the frequency of seizures, but they often do not stop the onset of the child. The thermal and radiation effects on the surrounding vital structures and the impossibility of complete control of the lesion limit the treatment with radiotherapy and stereotactic therapy. When pharmacological treatment is not possible, the child may be considered for surgical treatment. In recent years, with the development of microsurgical techniques, surgical treatment of epilepsy has become increasingly sophisticated. After total excision of hypothalamic malformation tumors, laughter epilepsy can disappear completely, and after partial excision laughter epilepsy is reduced. Although partial excision of the lesion helps in the control of epilepsy, only complete removal of the lesion can effectively control epilepsy. The rationale is that after surgical removal of a partial malformation tumor, the residual tissue can still secrete epileptogenic neuropeptides and thus epilepsy is not improved. Experts emphasize that there is a clear understanding of the clinical manifestations of laughter epilepsy associated with hypothalamic malformation tumors, and MRI imaging of the third ventricular region should be performed in children with laughter epilepsy, regardless of the presence of precocious puberty. If antiepileptic drugs are ineffective, epilepsy is difficult to control and mental cognitive impairment is present, surgery should be actively performed.