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PubMed1977

Laughing and running fits as manifestation of early traumatic epilepsy.

Early traumatic epilepsy, whose frequency is rather high, especially in children, is usually characterized by focal motor seizures (57%) or by generalized seizures (43%). The association of both running and laughing fits in the same patient on the contrary is quite exceptional, as only three cases have been reported in literature. There are no observations about temporal lobe epilepsy, nor, particularly, about running or laughing fits in early traumatic epilepsy. We report here the interesting case of a boy whose early traumatic epilepsy manifested itself as temporal lobe epilepsy characterized by running and laughter.

Child↗
PubMed2004

Pathological laughing and crying following traumatic brain injury.

The authors examined the prevalence and clinical correlates of pathological laughing and crying (PLC) using the Pathological Laughter and Crying Scale (PLAC) in 92 consecutive patients with acute symptoms 3, 6, and 12 months after traumatic brain injury (TBI). The prevalence of PLC during the first year after TBI was 10.9%. Compared to patients without PLC, patients with PLC had significantly more depressive, anxious, and aggressive behaviors and had poorer social functioning. Additionally, PLC was associated with the presence of anxiety disorder, and focal frontal lobe lesions, especially in the lateral aspect of the left frontal lobe. Findings revealed that prefrontal regulation of limbic circuits may be involved in the pathophysiology of this disturbed emotional expression.

Adolescent↗
PubMed2000

Gelastic seizures of neocortical origin confirmed by resective surgery.

Ictal laughter is a relatively unusual phenomenon that appears to arise from within hypothalamic hamartomas. Gelastic seizures of neocortical origin are rare and when reported typically originate from temporofrontal regions in proximity to the hypothalamus, raising the possibility of a subtle lesion in the hypothalamus. A girl with gelastic seizures originating in a dysembryoblastic neuroepithelial tumor at the cranial vertex had resolution of her seizures following surgical resection. Electrical propagation of seizures via the cingulate gyrus appears to be an alternative mechanism underlying gelastic seizures.

Brain Neoplasms↗
PubMed1989

Angelman's (happy puppet) syndrome: clinical, CT scan and serial electroencephalographic study.

Of four patients having Angelman's syndrome admitted to a state mental facility who were clinically and electroencephalographically evaluated, 2 patients had CT scan studies of the brain. The most impressive and striking features that help in the diagnosis are the mental and physical retardation, nondevelopment of speech despite adequate visual and auditory function, various types of seizures, and episodic uncontrollable laughter. The CT scans of the brain did not offer any clue as to the pathogenesis. The EEGs appeared to fall into two groups: in one an arrest of electrical maturation occurred between ages 1 and 3 and in the other a slow but progressive maturation was evident.

Adolescent↗
PubMedDate not supplied

Frequency of use of complementary and alternative medicine in women with breast cancer.

PURPOSE/OBJECTIVES: To estimate the frequency of use of complementary and alternative medicine (CAM) therapies among women diagnosed with breast cancer and to identify demographic and clinical factors associated with CAM use in these patients. DESIGN: A descriptive, cross-sectional survey. SAMPLE: A convenience sample of 105 predominantly Caucasian women (mean age = 59 years) with a diagnosis of breast cancer was recruited from the Tampa Bay area and a rural midwestern area. METHODS: Utilizing the "Use of Complementary Therapies Survey," frequency of CAM use was calculated for 33 individual therapies listed on the survey and among three survey-defined subscales of CAM therapies (i.e., diet and nutritional supplements, stress-reducing techniques, and traditional and ethnic medicines). MAIN RESEARCH VARIABLES: Use of CAM therapies and types of treatment in women with breast cancer. FINDINGS: Among diet and nutritional supplements, 64% of all participants reported regular use of vitamins and minerals and 33% regularly used antioxidants, herbs, and health foods. Among stress-reducing techniques, 49% of all participants regularly used prayer and spiritual healing, followed by support groups (37%) and humor or laughter therapy (21%). Traditional and ethnic medicine therapies rarely were used with the exception of massage, which 27% of all participants used at least once after diagnosis. More frequent CAM use was observed among study participants who had undergone previous chemotherapy treatment and those with more than a high school education. Also, being less satisfied with their primary physician was associated with patients' more frequent CAM use. CONCLUSIONS: CAM use is increasing among women with breast cancer, and frequency of specific use according to type of CAM is higher than what has been reported in other studies. Use increased in patients who had undergone chemotherapy and in those with a high school education. IMPLICATIONS FOR NURSING: Oncology nurses are in a key position to identify what treatments patients are using and implement CAM therapies that can be helpful to relieve patient symptoms related to treatment and psychological distress.

Age Factors↗
PubMed1984

Pseudocataplexy: gelastic-atonic seizures.

Gelastic-atonic seizures are characterized by laughing and then loss of muscle tone. They are difficult to differentiate from laughter-induced cataplexy and may be indicative of Niemann-Pick disease Type C or variants. We studied an 11-year-old girl who had gelastic-atonic seizures that were triggered by laughing. The nature of her attacks was established by ictal EEG ambulatory recordings at home. There was no evidence of Niemann-Pick disease.

Cataplexy↗
PubMed1993

Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment.

We retrospectively studied 12 consecutive patients with gelastic seizures and hypothalamic hamartomas who, because of intractable epilepsy, underwent chronic intracranial EEG monitoring or epilepsy surgery. All patients had medically refractory seizures that included laughter as an ictal behavior (gelastic seizures). The hypothalamic hamartomas were identified with neuroimaging studies (12 of 12) and by pathologic verification (four of 12). Associated clinical features included behavioral disorders (n = 5), developmental delay (n = 4), and precocious puberty (n = 2). Interictal extracranial EEG predominantly showed bi-hemispheric epileptiform changes suggesting a secondary generalized epileptic disorder. Intracranial EEG recordings, performed in eight patients, indicated the apparent focal onset of seizure activity (anterior temporal lobe [n = 7] and frontal lobe [n = 1]). None of the seven patients who underwent a focal cortical resection, however, experienced a significant reduction in seizure tendency. An anterior corpus callosotomy, performed in two patients with symptomatic generalized epilepsy, resulted in a worthwhile reduction in drop attacks. Results of this study may modify the surgical strategies in patients with gelastic seizures and hypothalamic hamartomas.

Child↗
PubMed1998

Hypothalamic hamartomas and gelastic epilepsy: a spectroscopic study.

BACKGROUND: Patients with hypothalamic hamartomas present with epileptic attacks of laughter and later experience multiple seizure types and cognitive decline, suggestive of secondary generalized epilepsy. It has been suggested in the past that gelastic seizures originate in the temporal lobes rather than in the hamartoma, but temporal resections have been ineffective. Recent electrophysiologic evidence suggests that the epileptogenic discharges may originate in the hamartoma itself. METHODS: We used proton magnetic resonance spectroscopic imaging to quantify the amount of neuronal damage in the temporal lobes and hamartomas of patients with hypothalamic hamartomas and gelastic seizures. Five patients were studied and the relative intensity of N-acetylaspartate to creatine (NAA/Cr) was determined for both temporal lobes as well as for the hamartoma. These values were compared with signals from the temporal lobes and hypothalami of normal control subjects. RESULTS: NAA/Cr was not significantly different from normal control subjects for either temporal lobe, nor was there a significant asymmetry between the two temporal lobes for any of the patients. NAA resonance signals were present in the hamartomas, and the ratio of NAA to Cr was decreased in the hamartomas compared with the hypothalami of normal control subjects (t = 4.5, p = 0.005). CONCLUSIONS: We found no detectable neuronal damage in the temporal lobes of patients with hypothalamic hamartomas and gelastic epilepsy. This is further evidence that gelastic seizures do not originate in the temporal lobes of these patients.

Adolescent↗
PubMed2000

"Pressure to laugh": an unusual epileptic symptom associated with small hypothalamic hamartomas.

Gelastic seizures are the hallmark of the epilepsy syndrome associated with hypothalamic hamartomas. Patients typically develop cognitive deterioration and refractory seizures. The authors describe three patients with small hypothalamic hamartomas without these features and thus identify a mild end to the clinical spectrum. All had the unusual symptom of "pressure to laugh," often without actual laughter. This symptom could be dismissed as psychogenic but should be recognized as a clue to the presence of this unusual lesion.

Adolescent↗
PubMed1985

Hypothalamic hamartoma: report of two cases.

Two histologically confirmed hypothalamic hamartomas, one in a 7-year-old boy and another in a 10-year-old boy, are reported. One patient had precocious puberty, epileptic laughter, and abnormal behavior; the other had cerebral seizures. Partial removal of the tumors had no effect on precocious puberty; however, behavior improved in the first patient, and seizure control improved in the second patient.

Child↗
PubMedDate not supplied

Use of humour in patient care.

Laughter and humour are an intrinsic part of our daily lives, but do nurses recognise the importance of humour in reducing stress and promoting feelings of wellbeing for patients and fellow staff members?

Attitude of Health Personnel↗
PubMed2000

Problem behaviors associated with 15q- Angelman syndrome.

Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss Screen for Maladaptive Behavior. Seventy-three replies were received, and comparisons were made with other published data. Responses indicated that 15q- Angelman syndrome is associated with such problems as lack of speech, overactivity, restlessness, and eating and sleep problems. Episodes of inappropriate laughter were only reported for 57%, despite being considered a cardinal feature of the syndrome; eating problems (64%) and a fascination with water (68%) were reported more frequently. Overactivity was more of a problem for children; Aberrant Behavior Checklist Factor IV (Hyperactivity) was negatively correlated with age. Scores were mostly lower than for previously studied etiological groups. Therapeutic effort should be put into programs to address these problems.

Adolescent↗
PubMed1995

Humor preferences among angered males and females: associations with humor content and sexual desire.

Previous research has indicated a connection between the appreciation of different content types of humor and the effectiveness of laughter to reduce a hostile mood. Although a person's state of arousal can influence the preferences shown for a particular type of humor, little research has examined how sexual desire may contribute to preferences for humor. Anger was experimentally induced in 180 men and 180 women who had noted sexual desire before exposure to humor with sexual, sexist, and neutral content. Assessment of appreciation scores showed that angered men and women preferred sexual and sexist humor when they reported high sexual desire. Mood assessment indicated this appreciation related to the removal of anger and the reporting of a happy state with low ratings of sexual desire. Participants preferred neutral humor and showed least appreciation of sexist humor. Also, they did not enjoy a reduction in their hostile mood following exposure to humor.

Adolescent↗
PubMed1988

Some sociocultural aspects of humour.

The social origins of laughter in homo sapiens, joking relationships and comic roles in both primitive and modern societies and reference group humour are all important to the psychiatrist in understanding the part played by humour in the social context presented by differing ethnic and social groups of patients. The use of humour by the medical profession, and particularly by the psychiatrist, is considered.

Cultural Characteristics↗
PubMedDate not supplied

Fluoxetine improves emotional incontinence.

Emotional incontinence is a behavioural syndrome characterized by involuntary weeping, grimacing, and/or laughter. We investigated the efficacy of fluoxetine in 13 patients with emotional incontinence. All 13 patients demonstrated dramatic improvement in emotional lability within 3 to 14 days.

Adult↗
PubMed1990

Laugh it off. The effect of humor on the well-being of the older adult.

1. Laughter releases excessive physical and psychological energy, and it reduces stress, anxiety, worry, and frustration. Humor as a skillful nursing intervention can enhance the overall well-being of older adults. 2. If the timing is inappropriate, humor can be a destructive rather than constructive intervention, especially in nursing situations where embarrassing, sensitive, or emotion-laden issues are at hand. 3. This study found that as one ages, one's self-perception of health seems to decrease. Therefore, nurses need to promote a positive outlook toward the aging process and one's own health status while interacting with the elderly in a variety of settings. 4. Nurses should be encouraged to explore the use of humor, not only with patients of all ages, but also with their nurse colleagues to help reduce burn out; to cope with the everyday stress and pressures inherent in the profession; and to enhance learning in the classroom.

Aged↗
PubMed1975

An ecological study of glee in small groups of preschool children.

A phenomenon called group glee was studied in videotpes of 596 formal lessons in a preschool. This was characterized by joyful screaming, laughing, and intense physical acts which occurred in simultaneous bursts or which spread in a contagious fashion from one child to another. A variety of precipitating factors were identified, the most prevalent being teacher requests for volunteers, unstructured lags in lessons, gross physical-motor actions, and cognitive incongruities. Distinctions between group glee and laughter were pointed out. While most events of glee did not disrupt the ongoing lesson, those which did tended to produce a protective reaction on the part of teachers. Group glee tended to occur most often in large groups (7-9 children) and in groups containing both sexes. The latter finding was related to Darwin's theory of differentiating vocal signals in animals and man.

Child, Preschool↗
PubMed2001

Gelastic epilepsy--a case report with SPECT studies.

A 24 years male presented with daily episodes of uncontrollable laughter followed by urinary incontinence since the age of nine years. Some of these attacks progressed to generalized tonic-clonic seizures. General and neurological examination did not reveal any abnormality. Ictal and interictal video EEGs were normal. MRI showed a hypothalamic hamartoma. Interictal SPECT scan showed normal perfusion in the hamartoma. SPECT scan obtained four minutes after beginning of seizure showed that the perfusion increased in right cingulate gyrus but not in the hamartoma, suggesting the involvement of the cingulate gyrus in the seizure origin or pathway.

Adult↗