Posterior Fossa Tumors With Pathological Laughter

Achari, Amrit N.; Colover, Jack

doi:10.1001/jama.1976.03260400035025

Cited by 41 publications

(8 citation statements)

References 5 publications

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“…A classic example of this phenomenon is pseudobulbar palsy resulting from bilateral damage to the descending pyramidal tracts, producing cranial nerve dysfunction as well as uncontrollable crying or laughing that is unrelated to or out of proportion to the patient's underlying mood. Often referred to as pseudobulbar affect (PBA), 1,2 this syndrome occurs in amyotrophic lateral sclerosis (ALS), [3][4][5] multiple sclerosis (MS), [6][7][8][9] stroke, [10][11][12][13][14][15][16] traumatic brain injury (TBI), [17][18][19] Alzheimer's disease, 20,21 Parkinson's disease, 22 and brain tumors, 23 among other disorders. Recent evidence suggests a link between the core symptoms of crying and laughing and a broader class of emotional disinhibition symptoms.…”

Section: Introductionmentioning

confidence: 99%

Defining and Diagnosing Involuntary Emotional Expression Disorder

et al. 2006

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Uncontrollable episodes of emotional expression occur in a variety of neurological conditions. This emotional disinhibition syndrome is characterized by episodes of crying or laughing that are unrelated to or out of proportion to the eliciting stimulus. This syndrome is common among patients with amyotrophic lateral sclerosis, multiple sclerosis, stroke, and traumatic brain injury and a variety of terms and definitions have been used to describe it. The confusing nomenclature has been a barrier to understanding, diagnosis, and treatment of this disorder. The authors propose a unifying term, involuntary emotional expression disorder (IEED), and provide diagnostic criteria for this disorder.

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Section: Introductionmentioning

confidence: 99%

Defining and Diagnosing Involuntary Emotional Expression Disorder

et al. 2006

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“…The “laughing tic” may, therefore, be regarded as a form of PL, since it satisfies this set of criteria; however, it is clinically distinct from other neuropathological conditions, discussed below, from which PL classically derives. PL is a clinical phenomenon presenting amidst a range of neuropsychiatric conditions,18 including epilepsy (gelastic seizures),19–21 cerebrovascular disease ( fou rire prodromique ),22–25 brain tumour,26–29 demyelinating disease,30, 31 and OCD 32, 33…”

Section: Discussionmentioning

confidence: 99%

Pathological laughter in Gilles de la Tourette syndrome: An unusual phonic tic

et al. 2010

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Patients with Gilles de la Tourette syndrome (GTS) can display socially inappropriate behaviors as part of their multiform tic phenomenology. Pathological laughter (PL), defined as the presence of episodic and contextually inappropriate outbursts of laughter, has been detailed as a symptom of various psychiatric and neurological conditions. We present a case series of eight subjects diagnosed with GTS who reported PL as part of their tic repertoire. All subjects experienced PL as a simple phonic tic, accompanied by characteristic premonitory urges and significant impairment in social interactions. In addition, all patients presented with multiple tic-related symptoms (mainly self-injurious behaviors and echolalia, n = 7; palilalia, n = 6; coprolalia/mental coprolalia, n = 5), and six patients had comorbid conditions (in particular obsessive-compulsive disorder/behaviors, n = 7; attention-deficit hyperactivity disorder, n = 4). We suggest that the pathophysiological mechanisms underlying the expression of PL as a tic could involve a dissociation between frontostriatal and limbic networks.

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“…Lesion‐behavior studies have also been of limited use for advancing our understanding the pathophysiology of PBA. Focal lesions causing PBA have been described in nearly every part of the brain, including frontal cortical and subcortical structures,4, 14–16 brainstem regions,14, 16–21 and anterior temporal regions 6. It has been observed in both unilateral and bilateral injury 4, 6.…”

Section: Cause Of Pseudobulbar Affectmentioning

confidence: 99%

A real reason for patients with pseudobulbar affect to smile

Rosen

Cummings

2007

Annals of Neurology

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Pseudobulbar affect (PBA) is a dramatic disorder of emotional expression and regulation characterized by uncontrollable episodes of laughing and crying that often cause embarrassment, curtailment of social activities, and reduction in quality of life. The disorder occurs in patients with brain injury caused by many types of neurological disease, including stroke, tumors, and neurodegenerative gray and white matter disorders. Although the pathophysiology is unknown, PBA may relate to release of brainstem emotional control centers from regulation by the frontal lobes. Diagnosis of PBA can be difficult and relies on careful characterization of episodes and differentiation from depression. Although there are no US Food and Drug Administration-approved treatments for PBA, several agents have been shown to be effective, including tricyclic antidepressants, selective serotonin reuptake inhibitors, and a new agent containing dextromethorphan and quinidine. The growing number of treatment options, some of great benefit to patients, highlights the importance of accurate diagnosis of this disorder.

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Posterior Fossa Tumors With Pathological Laughter

Cited by 41 publications

References 5 publications

Defining and Diagnosing Involuntary Emotional Expression Disorder

Defining and Diagnosing Involuntary Emotional Expression Disorder

Pathological laughter in Gilles de la Tourette syndrome: An unusual phonic tic

A real reason for patients with pseudobulbar affect to smile

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