SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
BACKGROUND: Pathological laughter can be a sign of epilepsy, psychiatric illness, effect of toxins or psychotropic drugs or of structural brain disease. METHOD: Case Studies. RESULT: Two patients developed inappropriate uncontrollable laughter following intravenous sodium valproate for treatment of epilepsy. CONCLUSION: Pathological laughter can be a side effect of intravenous sodium valproate.
PURPOSE: Substantial data are missing about the anatomic location of frontal regions supporting gelastic seizures. METHODS: We report the results of stereo-electro-encephalographic recordings performed over several distinct functional premotor and executive fields in a patient whose seizures were characterized by dyskinetic behavior and ictal laughter, in the absence of cerebral MRI abnormalities. RESULTS: The epileptogenic zone was circumscribed in the anterior and ventral part of the supplementary motor area and the underlying dorsal cingulate cortex. There were no or little spreading to cortical neighboring areas. The patient is seizure-free (follow-up of 27 months) after a stereotactic electric radiofrequency lesion of the epileptogenic focus. CONCLUSION: The present data suggest that pericingulate premotor areas are involved in the triggering of the motor component of laughter. In this case, the coexistence of paroxysmal dyskinesias during laughter might reflect the involvement of specific compartment(s) of the basal ganglia.
The purpose of this study was to determine cardiovascular responses to laughter. The CO(2) rebreathing method was used to determine cardiac output and understand the role of the central and peripheral components of oxygen consumption and its relation to energy expended. Eight college-age subjects participated in this study. During periods of 5 minutes each, while sitting in a comfortable chair, subjects first rested, then viewed a videotape of a well-known comedian, then remained sitting. A repeated-measures analysis of variance was used to analyze the data. During laughter, there were significant increases in stroke volume and cardiac output and significant decreases in arteriovenous oxygen difference and total peripheral resistance. Following laughter, there was a significant decrease in oxygen consumption.
Distraction and relaxation have been controlled in previous studies as possible mechanisms for the effectiveness of mirthful laughter in coping with pain and discomfort. The purpose of this study is to control expectation of benefit from laughter. Discomfort thresholds for a blood pressure cuff at the upper dominant arm were recorded immediately before and after exposure to either a humorous or a relaxation video. Instructional sets led participants to believe that the video would either increase or decrease their sensitivity to discomfort. A 5th group watched the humorous video without manipulation of expectation. All participants completed A. Ziv's (1979) Sense of Humor Questionnaire (SHQZ). Humor and relaxation videos raised discomfort thresholds, and the effect of both video types was enhanced by expectations. Humorous personality trait (SHQZ) did not moderate effects. The larger issue of whether mirthful laughter has any unique benefit for pain or discomfort control beyond the effects of relaxation, distraction, or expectation is discussed.
Positive emotional activities have been suggested as modifiers of neuroendocrine hormones involved in the classical stress response. To detect changes in these components during a mirthful laughter experience, the authors studied 10 healthy male subjects. Five experimental subjects viewed a 60 minute humor video and five control subjects did not. Serial blood samples were measured for corticotropin (ACTH), cortisol, beta-endorphin, 3,4-dihydrophenylacetic acid (dopac)--the major serum neuronal catabolite of dopamine, epinephrine, norepinephrine, growth hormone, and prolactin. Repeated measures analysis of variance showed that cortisol and dopac in the experimental group decreased more rapidly from baseline than the control group (p = 0.011, p = 0.025, respectively). Epinephrine levels in the experimental group were significantly lower than the control at all time points (p = 0.017). Growth hormone levels in the experimental group significantly increased during baseline (p = 0.027) and then decreased with laughter intervention (p less than 0.0005), whereas, the controls did not change over time (p = 0.787). ACTH, beta-endorphin, prolactin, and norepinephrine levels did not significantly increase. The mirthful laughter experience appears to reduce serum levels of cortisol, dopac, epinephrine, and growth hormone. These biochemical changes have implications for the reversal of the neuroendocrine and classical stress hormone response.
Laughter and tears are natural resources that are often neglected in managing personal and professional stress. Facilitating patients' and families' laughter and tears is an important skill in providing emotional support, which is central to the caring role of nursing. Social stigmas, the medical model, and stressful hospital environments can distract nurses from employing these resources and other catharses in managing stress and supporting patients and families. Nurses can learn to integrate laughter and tears practically and appropriately into nursing care, thereby increasing work satisfaction and facilitating emotional healing.
Pathological laughter was stimulated by pursuit eye movements with a large extramedullary brainstem tumour. Laughter was also evoked by intense direct light. The mechanism by which visual stimuli could induce pathological laughter is discussed.
A 33-year-old male presented with involuntary and inappropriate laughter. Neuroimaging revealed a meningioma ventrolateral to the pons and midbrain, attached to the medial middle tentorium on the left side. The pathological laughter ceased immediately after subtotal removal of the tumor. Pathological laughter may be an early focal sign of a mass compressing ventrolateral brainstem.
This study examined the effect of a brief period of forced laughter on the mood of adults. Participants (N=17) rated their mood before and after 1 min. of forced laughter. Although the participants generally rated their mood as positive prior to the intervention, after forced laughter more participants rated positive affect significantly higher.
The case of a 40-year-old man with a clival chordoma who presented with symptoms of pathological laughter and left sixth cranial nerve paresis is reported. Laughing and talking during sleep were noted on polygraphic and videotape recordings of nocturnal sleep. Selective disorganization of sleep was observed, with laughing facial expressions and a lack of muscular atonia. The tumor developed in the prepontine cistern, compressing the pontomesencephalic structures backward and involving the upper clivus and the left cavernous sinus. No recurrence of laughter attacks were noted after total removal of the tumor. The sleep patterns observed were similar to those of experimental animals with lesions of the peri-alpha locus ceruleus. The importance of uncontrolled laughter as a sign of a ventral brain-stem mass is emphasized.
CONTEXT: Humor therapy and the related mirthful laughter are suggested to have preventive and healing effects. Although these effects may be mediated by neuroendocrine/neuroimmune modulation, specific neuroimmune parameters have not been fully investigated. OBJECTIVE: To determine the efficacy of mirthful laughter to modulate neuroimmune parameters in normal subjects. DESIGN: A series of 5 separate studies based on a multivariate repeated measures design, with post hoc simple contrast analysis. SETTING: The schools of medicine and public health at Loma Linda University, Loma Linda, Calif. SUBJECTS: 52 healthy men. INTERVENTION: Viewing of a humor video for 1 hour. Blood samples were taken 10 minutes before, 30 minutes into, and 30 minutes and 12 hours after the intervention. MAIN OUTCOME MEASURES: Natural killer cell activity; plasma immunoglobulins; functional phenotypic markers for leukocytes including activated T cells, nonactivated T cells, B cells, natural killer cells, T cells with helper and suppressor markers, and assessment of plasma volume and compartmental shifts; plasma cytokine--interferon-gamma; and total leukocytes with subpopulations of lymphocytes, granulocytes, and monocytes. RESULTS: Increases were found in natural killer cell activity (P < .01); immunoglobulins G (P < .02), A (P < .01), and M (P < .09), with several immunoglobulin effects lasting 12 hours into recovery from initiation of the humor intervention; functional phenotypic markers for leukocyte subsets such as activated T cells (P < .01), active cytotoxic T cells (P < .01), natural killer cells (P = .09), B cells (P < .01), helper T cells (P < .02), uncommitted T cells with helper and suppressor markers (P < .02), helper/suppressor ratio (P = .10) with several leukocyte subset increase effects lasting 12 hours after the humor experience; the cytokine interferon-gamma (P = .02), with increases lasting 12 hours; total leukocytes (P < .05), with specific subpopulation lymphocytes during the intervention (P < .01) and 90 minutes into recovery (P < .05); and granulocytes during the intervention (P < .05) and 90 minutes following the intervention (P < .01). CONCLUSION: Modulation of neuroimmune parameters during and following the humor-associated eustress of laughter may provide beneficial health effects for wellness and a complementary adjunct to whole-person integrative medicine therapies.
A 46 year old man with trigeminal schwannoma displayed symptoms of ataxia with pathological laughter and crying. The tumour developed in the cerebellopontine angle, compressing the pontomesencephalic structures backward, extending in the posterior parasellar region and Meckel's cave. No recurrence of laughter and crying attacks were noted after total removal of the tumour. Theories of mechanism of pathological laughter and crying reported in the literature are reviewed.
INTRODUCTION: Pathological laughter occurs in pseudobulbar paralysis, in psychiatric disorders and as a sign of convulsions (gelastic crisis). An extremely rare form is the "fou rire prodromique' a pathological episode of laughter preceding a stroke. The pathogenesis is unknown and classically differentiated from gelastic crises. "Fou rire prodromique' has been described in subcortical ischaemic or haemorrhagic strokes, not in cortical strokes. CLINICAL CASE: We describe a patient with an ischaemic cerebrovascular accident due to embolism of the left Sylvian artery. The clinical picture started with a short episode of pathological laughter which preceded sensitive aphasia and weakness of the right limbs. CONCLUSIONS: We suggest that in the case described it is impossible to differentiate between the "fou rire prodromique' and a gelastic crisis as a first sign of an embolic cerebrovascular accident.
Detailed study of 4 patients and review of the literature allowed us to delineate further the epileptic syndrome associated with hypothalamic hamartomas, which characteristically begins in infancy with laughing seizures. Because early childhood psychomotor development is usually normal, the condition appears benign and may not even be recognized. The episodes of laughter are brief, frequent, and mechanical in nature. These features distinguish it from other forms of epileptic laughter, particularly that which occurs in temporal lobe epilepsy. Subsequently, the seizures become longer, other seizure types appear, and between the ages of 4 and 10 years, the clinical and electroencephalographic features of secondary generalized epilepsy develop. Cognitive deterioration occurs and severe behavior problems are frequent. Prognosis for seizure control and social adjustment is poor. Cortical abnormality occurs in association with the hypothalamic hamartoma. The lesions are best detected by magnetic resonance imaging but may be difficult to identify by computed tomographic scanning.
A patient with fits of laughter due to a tumorous alteration (hyperplasia) of the floor of the third ventricle is described with electroencephalographic findings indicative of focal epilepsy (complex partial seizures = psychomotor fits). The laughter is interpreted as an inborn emotional expression with structural substrate in the hypothalamus and neighboring brain. With structures remaining intact functional disorders in this area can cause epileptic phenomena with participation of the limbic system.
Following hypotheses by Darwin and Hecker on the connection between tickling and humorous laughter, questionnaire data were collected from 100 college students regarding their reported ticklishness and tendencies to laugh and show responses ancillary to laughter. Ticklishness was related to propensities to: (a) giggle, (b) laugh, (c) smile, (d) piloerect, (e) blush, and (f) cry. These findings lend preliminary support for the Darwin-Hecker conjecture that reflexes underlying ticklishness mediate humor. We speculate on possible relations among tickling and humor, and reasons why people laugh and smile when they find things funny.
Laughter is a very special phenomenon. Unfortunately, its (psycho)therapeutic value is underestimated and its transforming force is not used to its full extent. Next to spontaneous laughter, there is also a laughing meditation, a structured exercise of 15 min with 3 stages: stretching, laughing (and/or crying), silence. The laughing meditation can be used as 'adjuvans' in all kinds of therapy and, in other situations it enhances the coping with all of life's woes. This can be done alone or in any group. It facilitates the viewing of problems from another angle and it makes life lighter. Responses from participants indicate a deep relaxation, a feeling of being 'whole', a feeling of being 'unburdened', I feel my tears or I feel sad, a feeling of acceptance of the present.
A man experienced one hour and 40 minutes of continual, inappropriate, uncontrollable laughter. The onset was preceded by a single-inhalation exposure to an insecticide of very low toxicity. The episode was terminated by a single dose of IV diazepam. A discussion of pathological laughter, including its proposed pathophysiology, differential diagnosis, clinical relevance, and management, is presented.