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Pathological Laughing: Brain SPECT Findings.

David Morland¹, Valérie Wolff, Cyrille Blondet

¹From the *Service de Biophysique et Médecine Nucléaire and †Unité Neuro-vasculaire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ‡Université de Strasbourg, EA 3072, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; and §ICube, Université de Strasbourg/CNRS (UMR 7357), Strasbourg, France.

Clinical Nuclear Medicine

|April 23, 2015

Summary

This summary is machine-generated.

Uncontrollable laughing after a stroke may signal brain changes. Treatment with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), effectively managed these emotional dysregulation episodes.

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Area of Science:

Neurology
Neuroimaging
Neuropsychiatry

Background:

Brainstem strokes can disrupt emotional regulation.
Ischemic stroke in the pons can lead to complex neurological deficits.

Observation:

A 40-year-old man experienced uncontrollable laughing episodes unrelated to happiness.
Symptoms began seven months post-pontine ischemic stroke due to basilar and left vertebral artery occlusion.

Findings:

Brain perfusion SPECT revealed hypoperfusion in the right frontal inferior and temporoinsular regions.
This pattern suggested a diaschisis phenomenon impacting laughing regulation pathways.
No epileptic activity or new MRI lesions were identified.

Implications:

Pontine lesions can cause diaschisis, affecting distant brain regions involved in emotional control.
Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine can be effective in treating post-stroke emotional lability.
Understanding these pathways is crucial for managing post-stroke behavioral changes.