Latah: An indonesian startle syndrome

Abstract

The nature of culture-specific startles syndromes such as "Latah" in Indonesia and Malaysia is ill understood. Hypotheses concerning their origin include sociocultural behavior, psychiatric disorders, and neurological syndromes. The various disorders show striking similarities despite occurring in diverse cultural settings and genetically distant populations. They are characterized clinically by exaggerated startle responses and involuntary vocalizations, echolalia, and echopraxia. Quantifying startle reflexes may help define Latah within the 3 groups of startle syndromes: (1) hyperekplexia, (2) startle-induced disorders, and (3) neuropsychiatric startle syndromes. Twelve female Latah patients (mean age, 44.6 years; SD, 7.7 years) and 12 age-, sex- and socioeconomically matched controls (mean age, 42.3 year; SD, 8.0) were studied using structured history taking and neurological examination including provocation of vocalizations, echolalia, and echopraxia. We quantified auditory startle reflexes with electromyographic activity of 6 left-sided muscles following 104-dB tones. We defined 2 phases for the startle response: a short latency motor startle reflex initiated in the lower brain stem <100/120 ms) and a later, second phase more influenced by psychological factors (the "orienting reflex," 100/120-1000 ms after the stimulus). Early as well as late motor startle responses were significantly increased in patients compared with controls (P ≤ .05). Following their startle response, Latah patients showed stereotyped responses including vocalizations and echo phenomena. Startle responses were increased, but clinically these proved insignificant compared with the stereotyped behavioral responses following the startle response. This study supports the classification of Latah as a "neuropsychiatric startle syndrome."

The spectrum of involuntary vocalizations in humans: A video atlas

“…Other reported etiologies are early‐onset schizophrenia and membranous lipodystrophy . Finally, palilalic behaviors may also be encountered in functional neurological disorders and in culture‐bound startle syndromes (eg, Indonesian Latah; also see below) . Of note, palilalia should be distinguished from stuttering, a disorder with dysfluency of speech and repetition of sounds, syllables, or words (eg, Video 1A, palilalia vs Video 1K, stuttering) …”

“…96 Finally, palilalic behaviors may also be encountered in functional neurological disorders 52 and in culture-bound startle syndromes (eg, Indonesian Latah; also see below). 97 Of note, palilalia should be distinguished from stuttering, a disorder with dysfluency of speech and repetition of sounds, syllables, or words (eg, Video 1A, palilalia vs Video 1K, stuttering). 98,99 Echolalia Echolalia is the automatic imitative repetition of sounds, words, or phrases in the absence of explicit awareness.…”

“…For example, patients with culture-bound startle syndromes, such as Latah (also see section on palilalia), typically vocalize following a loud external stimulus. 97 Patients with functional movement disorders may also show similarly exaggerated stimulus-triggered responses (Video 6). This type of vocalized startling differs from the classic motor startle response in hyperekplexia.…”

Startle Reflex and Health

“…), many of which are stereotypical and similar across cultures. Bakker et al (2013) compared eyeblink EMG measures of startle in Latah patients with those of matched control participants and found that this measure of startle was larger and more probable in the patients, but no differences in onset latency or habituation were found. However, startle components in the neck and body muscles were more probable and faster in patients, and they habituated more slowly.…”

Differentiation of Zaghrouta, Ululation to Express Joy in the Middle East, from Movement Disorders and Other Conditions

“…Additionally, an example of a normal startle response with a secondary abnormal response is startle epilepsy, a condition in which a normal startle results in a focal frontal lobe seizure (10,12). Examples of exaggerated startle responses that may represent pathological syndromes in specific ethnic groups (10,12) including Latah in Malay people (13)(14)(15), Jumping Frenchmen of Maine (16), and Ragin' Cajuns of Louisiana (17). For example, Latah can be triggered by sudden shock resulting in screaming, dancing and cursing.…”