Pathological Laughter as a Presenting Symptom of Trigeminal Neurinoma —Case Report—

Abstract

A 26-year-old male presented with a trigeminal neurinoma manifesting as pathological laughter. After resection of the large tumor, the symptom disappeared completely. Pathological laughter sometimes precedes other manifestations of tumors around the brainstem and may be a useful localizing sign.

Treatment of Pathological Crying with Citalopram

“…In our first case, we could not find any definite indications regarding damage actually causing the pathological crying. On the other hand, analogous observations made by other authors strongly imply that ischemic damage to the brain stem (specifically, the pons) was centrally involved in the pathological crying etiology in our second case [2,4,7,16,21].…”

“…This occurs especially frequently in amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS) or vascular lesion [2,9,11,12,17,19]. Rarer manifestations have been described, such as in tumors with compression of structures of the brain stem [7,16,21], vascular malformations [4], Parkinsons disease [8,13], and closed craniocerebral trauma [31].…”

Pathological laughter in a patient with Rathke cleft cyst

“…Although the ''laughter center" is still a controversial notion, many researchers believe that the center for laughter is located in the upper brainstem. 5,6,[19][20][21][22] For example, hypothalamic hamartoma might have an influence on the anterior and posterior corticobulbar descending pathways, which could lead to PL. PL is a disorder of emotional expression rather than a primary disturbance of feelings.…”

Trigeminal neuralgia: no laughing matter

“…Poeck3 postulated a pontine ‘coordination centre’ for laughter, while Brown4 suggested the peri-aqueductal grey matter and its connections to the reticular formation as a synchronising mechanisms coordinating laughter, crying and rage, by integrating facial expression, breathing and autonomic reactions. Several brainstem lesions have been implicated in pathological laughter, most frequently such as a trigeminal neuroma located ventrally,5 menigioma located ventromedially to the seventh and eighth cranial nerve nuclei,6 clival chordoma7 and petroclival menigioma distorting the upper brainstem 8. In a study of pontine infarctions, only those in a paramedian basal location led to pathological laughter, and this only rarely 9.…”