Affiliations: Department of Neurology, Edith Wolfson Medical Center,
Holon 58100, Israel Affiliated to Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv, Israel | Pediatric Neurology Unit, Edith Wolfson Medical
Center, Holon 58100, Israel Affiliated to Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv, Israel
Note: [] Corresponding author: R. Dabby, M.D. Department of Neurology,
Wolfson Medical Center, Holon 58100, Israel. Tel./Fax: +1 972 3 5028513;
E-mail: [email protected]
Abstract: Pathological laughter is an uncommon symptom usually caused by
bilateral, diffuse cerebral lesions. It has rarely been reported in association
with isolated cerebral lesions. Midbrain involvement causing pathological
laughter is extremely unusual. We describe three patients who developed
pathological laughter after midbrain and pontine-midbrain infarction. In two
patients a small infarction in the left paramedian midbrain was detected,
whereas the third one sustained a massive bilateral pontine infarction
extending to the midbrain. Laughter heralded stroke by one day in one patient
and occurred as a delayed phenomenon three months after stroke in another.
Pathological laughter ceased within a few days in two patients and was still
present at a two year follow-up in the patient with delayed-onset laughter.
Pathological laughter can herald midbrain infarction or follow stroke either
shortly after onset of symptoms or as a delayed phenomenon. Furthermore, small
unilateral midbrain infarctions can cause this rare complication.
