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A survey about laughter upon viewing functional seizures.

Mohamad Z Koubeissi1, Nadim Jaafar1, Christopher Saouda1

  • 1Department of Neurology, The George Washington University, Washington, DC, United States.

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|February 19, 2026
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Summary

Physicians sometimes laugh at functional seizures (FS) due to diagnostic skepticism or perceived deception. Understanding these reactions is key to improving care for patients with functional disorders.

Keywords:
behaviorclinical practicefunctional seizureslaughternonepileptic seizures

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Area of Science:

  • Neurology
  • Psychiatry
  • Medical Education

Background:

  • Laughter is frequently observed among physicians when encountering functional seizures (FS) and other functional disorders.
  • This reflexive response occurs in clinical settings and during medical conference presentations.

Purpose of the Study:

  • To investigate the underlying factors contributing to physicians' laughter in response to the diagnosis of FS.
  • To explore differences in laughter triggers between physicians and non-physicians.

Main Methods:

  • A 5-year survey study involving 221 participants (physicians and non-physicians) across diverse geographical locations.
  • Analysis of observational data on laughter responses to FS videos in various settings (U.S. grand rounds, international conferences, non-medical audiences).

Main Results:

  • Physicians attributed laughter to superiority, diagnostic skepticism, or perceived patient deception, while non-physicians cited defense mechanisms, negative opinions, and ignorance.
  • U.S. physicians reported more discomfort, negative opinions, and ignorance compared to non-U.S. physicians.
  • Laughter prevalence varied significantly by setting, with higher rates at U.S. medical grand rounds.

Conclusions:

  • Laughter in response to FS may serve adaptive functions in managing complex cases.
  • Addressing misperceptions about functional disorders is crucial for equitable patient care.
  • Fostering deeper clinician understanding is essential for improving the management of patients with FS.