Gelastic Presyncope: An Unusual Manifestation in an Elderly Patient

Recurrent Laughter-induced Syncope

“…Since the description of laughing syncope by Cox et al, 1 only 15 other cases of laughing (or gelastic) syncope have been published in the literature to the best of our knowledge. [2][3][4][5][6][7][8][9][10][11][12][13][14] Most cases were neurally mediated syncopes triggered by laughter 2-4,6,7,10,12,13 similar to our case. Two individuals had attacks of near syncope only.…”

“…Two individuals had attacks of near syncope only. 12,13 Laughter-induced syncope was a single event in most individuals, 1,2,[4][5][6][7]9,10,13 with only 2 previously reported cases having multiple episodes of laughing syncope. 8,13 A few cases had multiple syncopes also triggered by coughing, defecation, or micturition.…”

“…8,13 A few cases had multiple syncopes also triggered by coughing, defecation, or micturition. 3,12 Five cases occurred in people with an underlying neurological condition. 1,5,9,11,14 One patient had severe brachiocephalic trunk stenosis with attacks accompanied by transient monocular blindness that disappeared after vascular stenting 1 ; 1 had Takayasu arteritis with marked narrowing of the bilateral common carotid and subclavian arteries that resolved after a revascularization procedure 14 ; another had lacunar pseudobulbar palsy with attacks triggered by spasmodic laughter managed with bisoprolol 10 ; and 1 had a cerebellar ependymoma with syncopal attacks after episodes of pathologic laughter that responded to tumor resection.…”