Postural Reflex Gelastic Seizures

Jacome, DE; Lw, McLain; Fitzgerald, Robert D.

doi:10.1001/archneur.1980.00500530087020

Cited by 23 publications

(13 citation statements)

References 14 publications

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“…A brief sketch of those locations (Figure 5) that are reported to elicit mirthful behavior reveals that they appear to occur primarily within in a pyramid defined by the STN, NA, medial temporal cortex (MTC), and hypothalamus (HT). This data fits with current neurological models and the results of functional imaging, which posit pathways for the motor and emotional components of laughter that are initially separate but then merge at the level of the brainstem (Poeck et al, 1963), with the ‘emotional laughter’ pathway routing through the temporal lobes(Jacome et al, 1980; Oehl et al, 2009) and other limbic aspects of the basal ganglia(Wild et al, 2003). Our observations may provide the following elaboration on this schema: the NAc region appears more closely tied to euphoria rather than context-dependent mirth.…”

Section: Discussionsupporting

confidence: 83%

Smile and laughter induction and intraoperative predictors of response to deep brain stimulation for obsessive-compulsive disorder

et al. 2011

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We recently treated six patients for OCD utilizing deep brain stimulation (DBS) of the anterior limb of the internal capsule and the nucleus accumbens region (ALIC-NA). We individually tested leads via a scripted intraoperative protocol designed to determine DBS-induced side effects and mood changes. We previously published qualitative data regarding our observations of induced emotional behaviors in our first five subjects. We have now studied these same behaviors in the full cohort of six patients over two years of follow-up and have examined the relationship of these behaviors to intraoperative mood changes and postoperative clinical outcomes. Five patients experienced at least one smile response during testing. At higher voltages of stimulation some of these smiles progressed to natural laughter. Smiles and laughter were associated with mood elevation. At stimulation locations at which smiles were observed, voltage and mood were significantly correlated (p=0.0004 for right brain and p<0.0001 for left brain). In contrast, at contacts where smiles were not observed, mood was negatively correlated with voltage (p=0.0591 for right brain and p=0.0086 for left). Smile and laughter-inducing sites were located relatively medial, posterior, and deep in the ALIC-NA. The presence of stimulation induced laughter predicted improvement in OCD symptoms at two years. The higher the percentage of laugh conditions experienced in an individual patient, the greater the reduction in YBOCS (24 months, p=0.034). Other correlations between clinical outcomes and percent of smile/laugh conditions were not significant. These stimulation-induced behaviors were less frequently observed with one and two-month postoperative test stimulation and were not observed at subsequent test stimulation sessions. Intraoperative stimulation-induced laughter may predict long-term OCD response to DBS. Identifying other potential response predictors for OCD will become increasingly important as more patients are implanted with DBS devices. A larger study is needed to better delineate the relationship between induced intraoperative and postoperative emotional behavior and clinical outcome in patients treated with DBS therapy.

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Section: Discussionsupporting

confidence: 83%

Smile and laughter induction and intraoperative predictors of response to deep brain stimulation for obsessive-compulsive disorder

et al. 2011

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“…During gelastic seizures, some patients report pleasant feelings which include exhilaration or mirth (Jacome et al, 1980;Arroyo et al, 1993;Sturm et al, 2000). Other patients experience the attacks of laughter as inappropriate and feel no positive emotions during their laughter (Assal et al, 1993;Munari et al, 1995;Berkovic et al, 1997;Iannetti et al, 1997;Kuzniecky et al, 1997;Cerullo et al, 1998;Georgakoulias et al, 1998;Tasch et al, 1998;Striano et al, 1999).…”

Section: Gelastic Epilepsymentioning

confidence: 99%

Neural correlates of laughter and humour

Wild

Rodden²,

Grodd³

et al. 2003

Brain

325

236

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Although laughter and humour have been constituents of humanity for thousands if not millions of years, their systematic study has begun only recently. Investigations into their neurological correlates remain fragmentary and the following review is a first attempt to collate and evaluate these studies, most of which have been published over the last two decades. By employing the classical methods of neurology, brain regions associated with symptomatic (pathological) laughter have been determined and catalogued under other diagnostic signs and symptoms of such conditions as epilepsy, strokes and circumspect brain lesions. These observations have been complemented by newer studies using modern non-invasive imaging methods. To summarize the results of many studies, the expression of laughter seems to depend on two partially independent neuronal pathways. The first of these, an 'involuntary' or 'emotionally driven' system, involves the amygdala, thalamic/hypo- and subthalamic areas and the dorsal/tegmental brainstem. The second, 'voluntary' system originates in the premotor/frontal opercular areas and leads through the motor cortex and pyramidal tract to the ventral brainstem. These systems and the laughter response appear to be coordinated by a laughter-coordinating centre in the dorsal upper pons. Analyses of the cerebral correlates of humour have been impeded by a lack of consensus among psychologists on exactly what humour is, and of what essential components it consists. Within the past two decades, however, sufficient agreement has been reached that theory-based hypotheses could be formulated and tested with various non-invasive methods. For the perception of humour (and depending on the type of humour involved, its mode of transmission, etc.) the right frontal cortex, the medial ventral prefrontal cortex, the right and left posterior (middle and inferior) temporal regions and possibly the cerebellum seem to be involved to varying degrees. An attempt has been made to be as thorough as possible in documenting the foundations upon which these burgeoning areas of research have been based up to the present time.

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“…A few patients have described feelings of mirth associated with laughter [14, 15, 16]or with a cause felt to be amusing. In 1 example, the seizures were evoked by hyperextension of the back; in 1 case, a sexual sensation was reported before the development of laughter.…”

Section: Gelastic Seizure With a Temporal Focusmentioning

confidence: 99%

A Note on Gelastic Epilepsy

Pearce

2004

Eur Neurol

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Laughter epilepsy or gelastic seizures have been described in various epilepsies arising from the temporal or frontal lobes, but most commonly from hypothalamic hamartomata. Gelastic seizures also arise from temporal and frontal lobe tumours and atrophic lesions. The essential clinical features are: stereotyped recurrence; absence of external precipitants; concomitance of other manifestations generally accepted as epileptic; presence of interictal or interictal EEG epileptiform discharges, and absence of conditions in which pathological laughter might occur. The history and clinical significance are discussed.

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Postural Reflex Gelastic Seizures

Cited by 23 publications

References 14 publications

Smile and laughter induction and intraoperative predictors of response to deep brain stimulation for obsessive-compulsive disorder

Smile and laughter induction and intraoperative predictors of response to deep brain stimulation for obsessive-compulsive disorder

Neural correlates of laughter and humour

A Note on Gelastic Epilepsy

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