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PubMedDate not supplied

Sick with laughter.

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Humans↗
PubMed1998

Rx: laughter.

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Adaptation, Psychological↗
PubMed2001

"Fou rire prodromique" as the presentation of pontine ischaemia secondary to vertebrobasilar stenosis.

"Fou rire prodromique" (prodrome of crazy laughter) is a rare form of pathological laughter of uncertain pathophysiology. A patient is presented with pathological laughter as the first manifestation of pontine ischaemia due to vertebrobasilar stenosis. A 65 year old man developed uncontrollable and unemotional laughter for almost an hour followed by transient right facial-brachial paresis. He had fluctuation of laughter, right facial brachial paresis, and occasional crying. Magnetic resonance imaging, magnetic resonance angiogram (MRA), and an angiogram showed small left pontine and cerebellar infarcts, left vertebral artery occlusion, and right vertebral and basilar artery stenosis. His condition deteriorated to bilateral brain stem infarction and he died. Necropsy confirmed the extensive brain stem infarction. Pathological laughter can be the very first presenting manifestation of ischaemia of the ventrotegmental junction of the upper pons. It is hypothesised that the pathological laughter in this patient was secondary to ischaemic ephaptic stimulation of the descending corticopontine/ bulbar pathways.

Aged↗
PubMed1993

Pathological laughing and crying following stroke: validation of a measurement scale and a double-blind treatment study.

OBJECTIVE: This study was undertaken to test the reliability and validity of the Pathological Laughter and Crying Scale and the effectiveness of nortriptyline treatment for patients with emotional lability following stroke. METHOD: Eighty-two patients with ischemic brain injury-54 who had been hospitalized with acute stroke and 28 others who requested treatment for pathological laughing and crying--were given standardized psychiatric and neurological assessments and then administered the Pathological Laughter and Crying Scale. The 54 acute stroke patients were used to evaluate the Pathological Laughter and Crying Scale, and the 28 patients with pathological emotional display were randomly assigned to nortriptyline treatment or placebo in a 6-week double-blind trial to assess the efficacy of a tricyclic antidepressant in treatment of this disorder. RESULTS: The interrater reliability on the Pathological Laughter and Crying Scale for a subgroup of 15 patients was 0.93, and the test-retest reliability of the scale was excellent. After 4 and 6 weeks of treatment, scores on the Pathological Laughter and Crying Scale showed significantly greater improvement in the 14 patients given nortriptyline than in the 14 given placebo. Although almost one-half of these patients also had major depression, the improvement in emotional lability was independent of depression status. In addition, response to treatment was not significantly affected by lesion location or time since stroke. CONCLUSIONS: The severity of symptoms in pathological emotional display can be reliably quantified with the Pathological Laughter and Crying Scale, and treatment with nortriptyline can effectively ameliorate this emotional disorder.

Affective Symptoms↗
PubMed1978

[Laughing in complex partial seizure epilepsy. A video tape analysis of 32 patients with laughing as symptom of an attack (author's transl)].

According to videotape analysis, laughter is a frequent (42.7%) symptom during psychomotor attacks. The results of our investigations show that it is no longer possible to regard it as a "curiosity", as did Janz (1969). It is an epileptic phenomenon like others and a symptom of automatism. It can occur in all phases of an attack. It is not remembered by the patient. We have been unable to establish any connection with age or sex. The form of expression is usually natural but inadequate and no affective motivation has been established. Laughter during an epileptic attack is an inborn emotional expression, structurally triggered by the involvement of the area around the hypothalamus-thalamic nucleus with the process causing the epilepsy. It is not actively experienced and is therefore not conscious and not an expression of the pleasant side of the affective complex moderated by the limbic system. The EEG's showed the usual variations occurring in psychomotor epilepsy. The temporal lobes are particularly involved. There is no "EEG Laughter Pattern". The group of patients considered here consist of severe, therapy-resistent cases of partial seizure epilepsy with pronounced cerebral lesions. In order to determine whether laughter is so common in less severe cases, a comparison group must be investigated. Laughter as a symptom of an epileptic attack is unknown to doctors and nursing staff and thus is either not recorded at all or, only very seldom. "Gelastic epilepsy" so-called does not exist as a nosology entity. This term should thus only be used--if at all--in cases where the laughter, together with a change in the level of consciousness, has over a period of years constantly been the only symptom of an attack, expecially when these attacks first became manifest in earliest childhood and are due to connatal changes in the hypothalamus-thalamic region.

Adolescent↗
PubMed1999

Gelastic seizures: video-EEG and scintigraphic analysis of a case with a frontal focus; review of the literature and pathophysiological hypotheses.

We report scalp EEG and SPECT findings in a young patient who experienced gelastic seizures; clinical, EEG and scintigraphic data strongly suggested a frontal focus in a context of cryptogenic epilepsy. Few cases of gelastic seizures originating in the frontal lobe have been reported in the literature, most of them involving a diencephalic hamartoma or a temporal focus although, no clinical pattern has been found to be specific for each of these three anatomical regions. The ictal laughter is of variable nature, unmotivated or associated with feelings of mirth, forced or natural, except in the case of a frontal focus where the laughter seems consistently described as forced and unmotivated. However, mirth and laughter are two dissociable clinical elements; their genesis probably involves distinct mechanisms. Anatomical considerations lead to several hypotheses concerning laughter generation: it could be a simple reactional behavior in response to a modified cognitive process, an automatic behavior or a forced action. In a few cases with a temporal focus, laughter seems directly related to a disorganization of the associative temporal cortex and may be considered as a reactional behavior. In cases with frontal focus, anterior cingulate and orbital structures would be particularly implicated in laughter genesis, although with possible different pathophysiological routes: in the first case by disconnection within the premotor mesial system or by an imbalance between premotor mesial and premotor lateral systems, and in the second case by activation of a previously conditioned orbital region.

Child, Preschool↗
PubMed2005

"Fou rire prodromique" associated with simultaneous bilateral capsular genu infarction.

Pathological laughter is exaggerated, uncontrollable, and inappropriate laughter usually unrelated to a true emotion or a congruent mood. "Fou rire prodromique" is a rare form of prodromal pathological laughter of uncertain pathophysiology that heralds an ischaemic neurologic deficit. We report a case of prodromal pathological laughter marking the onset of bilateral capsular genu infarction. T2-weighted cranial magnetic resonance imaging (MRI) showed bilateral capsular genu infarction. There was also a diffusion defect in the same areas on diffusion-weighted imaging (DWI). Although it is known that bilateral subcortical lesions can cause pathological laughter, this is the first demonstration of simultaneous associated bilateral capsular genu infarction on cranial DWI MRI.

Aged↗
PubMed2004

Tickle.

Tickle is a familiar sensation that may have two components: a light or feather-type noxious sensation termed by Hall and Allin as knismesis, and a heavy or laughter-associated sensation termed gargalesis. Studies on the sensation of tickle have generally been on one sensation or the other, but not on both. In pleasurable, laughter-associated tickle there are elements of touch and pleasure, but the sensation may be a synthesis of touch and itch, with receptors, neural pathways or central receptors different from knismesis. It is unclear why some skin sites are more ticklish than other sites. Laughter-associated tickle might best be considered a social behavior rather than a reflex. This behavior provides interaction between mother and child, helps to integrate a child with peers and adults in play, and may become part of the mating ritual or sexual foreplay. In tickle play there are elements of dominance and submission, with accompanying laughter and withdrawal developed as the signals of submission. In this scenario, ticklish areas of skin might be considered those areas most vital to the ticklee and allowed to be invaded in the dominance submission play.

Humans↗
PubMed1989

An EEG-mapping study of "laughing": coherence and brain dominances.

The human expressive behavior termed laughter is triggered by pleasurable psychoemotional stimuli (Moody, 1978) and is possessed of a certain healing potential. According to split-brain studies (Sperry, 1966), psychoemotional stimuli are bound up with emotional activity in the right side of the brain. The idea thus suggests itself to study laughter generated by different sources with regard to the attendant electric brain activity between the right and left hemispheres. The present study was undertaken first with subjects in a state of normal consciousness and subsequently-given the possibility of increased affect stimulation in connection with laughter-under hypnosis. Having familiarized ourselves in our earlier work on brain dominances with the brain mapping EEG and having convinced ourselves of its greater efficiency in comparison with conventional EEG (Bick, 1985), we have had recourse to this method in the present study on approaches to the neurophysiological processes in the brain connected with laughter.

Brain↗
PubMed1999

The emotional lability questionnaire: a new measure of emotional lability in amyotrophic lateral sclerosis.

In an ALS Clinic, use of the Pathological Laughter and Crying Scale of Robinson et al. [Robinson RG, Parikh RM, Lipsey JR, Starkstein SE, Price TR. Pathological laughter and crying following stroke: validation of a measurement scale and double-blind treatment study. American Journal of Psychiatry 1993;150(2):286-293] revealed several problems: reliance on self-rating, insufficient period of assessment, inadequate exploration of 'appropriateness of emotion', lack of an item for abnormal smiling, amusement rather than happiness being the cause of laughter in ALS, and a frequency-based rating system. The necessary modifications produced a new Emotional Lability Questionnaire (ELQ) that was tested in 43 ALS patients and 43 healthy controls. The self-rated version of the ELQ was administered as a structured interview to each participant, and the independent-relationship between subscales of the ELQ for both versions, thus confirming its internal validity. Greater emotional lability appeared associated with pseudobulbar symptoms. The question why 14 patients rated themselves as severely labile in the crying domain alone and four in the laughter domain alone, required further study.

Adult↗
PubMed2001

How humour keeps you well.

BACKGROUND: The beneficial effect of humour on health has long been recognised anecdotally and intuitively but studying and quantifying that effect is difficult. 'Studying humour is like dissecting a frog--you may know a lot but you end up with a dead frog.' (Mark Twain) OBJECTIVE: To describe some of the psychological and physiological effects of laughter and the health benefits of humour. DISCUSSION: Stress reduction has been shown to improve outcomes in the treatment of many health problems. While there are inherent difficulties in structuring studies to assess the impact of humour and laughter on health, positive psychological and physiological responses to laughter have been demonstrated in a variety of settings. In particular, laughter has a role in stress hormone reduction, improving mood, enhancing creativity, pain reduction, improving immunity and reducing blood pressure.

Australia↗