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Postictal laughter following absence status epilepticus
Laura S Boylan1, Thomas J Kaley, Anuradha Singh
1Department of Neurology, New York University School of Medicine, New York, NY, USA. laura.boylan@med.nyu.edu
Epilepsy & Behavior : E&B
|December 31, 2003
Summary
Pathologic laughter, a rare neurological symptom, was observed post-seizure in a patient with epilepsy. This case suggests diffuse cortical inhibition may release subcortical emotional expression centers.
Area of Science:
- Neurology
- Neuroscience
- Epileptology
Background:
- Pathologic neurologic laughter is typically an ictal phenomenon associated with epilepsy, brain stimulation, tumors, or stroke.
- The patient had medically refractory complex partial seizures and was admitted for phenytoin toxicity.
Observation:
- During video-electroencephalography (EEG) monitoring, the patient experienced absence seizures and absence status epilepticus.
- Immediately after the prolonged seizure episode, the patient exhibited several minutes of pathologic, mirthful laughter.
Findings:
- This is the first reported case of postictal (after a seizure) pathologic laughter.
- The laughter was followed by crying and a return to baseline neurological function.
Implications:
- The study proposes that diffuse cortical inhibition during or after seizures may disinhibit subcortical structures responsible for emotional expression.
- This case expands the understanding of the neural substrates of laughter and its potential manifestation in postictal states.