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Tentorial meningioma associated with pathological laughter--case report
S Tsutsumi1, S Hatashita, Y Kadota
1Juntendo University Urayasu Hospital, Urayasu, Chiba.
Neurologia Medico-Chirurgica
|May 1, 2002
Summary
Pathological laughter in a patient resolved after surgical removal of a brain tumor. This case suggests that inappropriate laughter can be an early indicator of brainstem compression from a mass.
Area of Science:
- Neurology
- Neurosurgery
- Neuro-oncology
Background:
- Pathological laughter is a neurological symptom characterized by involuntary and inappropriate emotional expression.
- Brainstem lesions, particularly meningiomas, can present with diverse neurological deficits.
- Identifying early focal signs is crucial for timely diagnosis and intervention.
Observation:
- A 33-year-old male exhibited episodes of involuntary and inappropriate laughter.
- Neuroimaging identified a meningioma situated ventrolateral to the pons and midbrain on the left side, adhering to the medial middle tentorium.
- The patient's symptom of pathological laughter resolved immediately following subtotal tumor resection.
Findings:
- The resolution of pathological laughter post-tumor removal strongly correlates the symptom with the brainstem mass.
- The location of the meningioma suggests a specific neuroanatomical pathway involved in emotional regulation or expression.
- This case highlights the potential for meningiomas in this region to manifest with unusual neurological signs.
Implications:
- Pathological laughter may serve as an early, focal neurological sign of a ventrolateral brainstem mass.
- Prompt neurosurgical evaluation is warranted in cases presenting with unexplained emotional dysregulation.
- Understanding the clinical presentation of brainstem tumors can improve diagnostic accuracy and patient outcomes.