“Seinfeld syncope”

Fall about laughing: A case of laughter syncope

“…We are aware of only two published reports of laugh syncope: one of a 62‐year‐old smoker with underlying coronary and peripheral arterial disease whose syncope was triggered by watching an episode of Seinfeld , 2 the other in an apparently healthy 32‐year‐old New York barber whose client had told him a joke 3 …”

Recurrent Laughter-induced Syncope

“…Two individuals had attacks of near syncope only. 12,13 Laughter-induced syncope was a single event in most individuals, 1,2,[4][5][6][7]9,10,13 with only 2 previously reported cases having multiple episodes of laughing syncope. 8,13 A few cases had multiple syncopes also triggered by coughing, defecation, or micturition.…”

“…3,12 Five cases occurred in people with an underlying neurological condition. 1,5,9,11,14 One patient had severe brachiocephalic trunk stenosis with attacks accompanied by transient monocular blindness that disappeared after vascular stenting 1 ; 1 had Takayasu arteritis with marked narrowing of the bilateral common carotid and subclavian arteries that resolved after a revascularization procedure 14 ; another had lacunar pseudobulbar palsy with attacks triggered by spasmodic laughter managed with bisoprolol 10 ; and 1 had a cerebellar ependymoma with syncopal attacks after episodes of pathologic laughter that responded to tumor resection. 9 A girl with Angelman syndrome had multiple episodes of asystole and syncope during outbursts of laughter attributed to vagal hypertonia; intravenous administration of atropine abolished asystole induced by laughter.…”

“…20 Impaired sympathetic activation during the Valsalva maneuver has also been suggested as the most likely cause for laughterinduced syncope. 3 The reflex mechanisms involved in neurally mediated syncope may contribute to syncope in cases with extracranial cerebrovascular disease, 1,14 where an increase in the intrathoracic pressure may compromise the blood flow and cerebral perfusion further. The mechanism in cases with central nervous system involvement 5,9,10 is not known.…”

Laughter-Induced Syncope

“…9 found to have 90% occlusion of his brachiocephalic trunk. 10 Being the only described case at the time, and the fact that the patient had such an extensive cardiovascular comorbidity, it was difficult to determine whether the syncope was laughter-induced or secondary to vascular occlusion. However, Bloomfield and Jazrawi 4 described a 32-year-old healthy male barber without demonstrable cardiovascular disease, who was told a funny story while cutting a client's hair, and then "blacked out" and fell to the floor.…”