Laugh-Induced Seizure
Introduction: A laugh-induced seizure is an unrecognized condition and to the best of our knowledge no case has been reported in the medical literature until now. We present an interesting and extremely rare case in which laughing generated the seizure activity that was recorded and confirmed by video electroencephalography.
Case presentation: A 43-year-old obese Caucasian man with history of bipolar disorder and chronic headache presented with multiple episodes of seizures, all induced by laughter while watching comedy shows. Each episode lasted approximately five seconds. In each instance, he started laughing, then his arms started shaking and he felt like 'his consciousness was being vacuumed away'. A physical examination revealed normal findings. He had been maintained on valproic acid for bipolar disorder and topiramate for his chronic headache, but this did not control his symptoms. His sleep-deprived electroencephalography and brain magnetic resonance imaging were normal except for an arachnoid cyst measuring 4.2 × 2.1cm in the anterior right middle cranial fossa. His video electroencephalography demonstrated laugh-induced seizure activities. He was then placed on carbamazepine. Following treatment, he had two episodes of mild staring but no frank seizures, and his seizures have remained well controlled on this regimen for more than a year.
Conclusions: Laugh-induced seizure is a most unusual clinical entity without any previous case report. Confirmatory diagnosis can be made by video electroencephalography recording of seizure activities provoked by laughing. As in gelastic seizure without hypothalamic hamartoma, our case responded well to polytherapy with topiramate and carbamazepine on top of laugh-provocation avoidance. Further study is required to establish the standard treatment of this condition.
Laughing is an entirely human quality and a part of everyday life. Laughter has a positive effect on measures of generalized well-being. Laugh-induced seizure is an extremely rare and probably unrecognized condition and thus can easily be misdiagnosed. However, it is very important to recognize this condition as early diagnosis and treatment may control the seizure activities and improve quality of life. To the best of our knowledge, no case of laugh-induced seizure has been reported in the medical literature. Based upon our case report, we discuss the fundamentals of this condition including clinical presentation, diagnostic modalities and possible treatment options, and differentiating features with the more common condition, the gelastic seizure. Seizure activities are induced by laughter in laugh-induced seizure but laughter is the manifestation of gelastic seizure.
Abstract and Introduction
Abstract
Introduction: A laugh-induced seizure is an unrecognized condition and to the best of our knowledge no case has been reported in the medical literature until now. We present an interesting and extremely rare case in which laughing generated the seizure activity that was recorded and confirmed by video electroencephalography.
Case presentation: A 43-year-old obese Caucasian man with history of bipolar disorder and chronic headache presented with multiple episodes of seizures, all induced by laughter while watching comedy shows. Each episode lasted approximately five seconds. In each instance, he started laughing, then his arms started shaking and he felt like 'his consciousness was being vacuumed away'. A physical examination revealed normal findings. He had been maintained on valproic acid for bipolar disorder and topiramate for his chronic headache, but this did not control his symptoms. His sleep-deprived electroencephalography and brain magnetic resonance imaging were normal except for an arachnoid cyst measuring 4.2 × 2.1cm in the anterior right middle cranial fossa. His video electroencephalography demonstrated laugh-induced seizure activities. He was then placed on carbamazepine. Following treatment, he had two episodes of mild staring but no frank seizures, and his seizures have remained well controlled on this regimen for more than a year.
Conclusions: Laugh-induced seizure is a most unusual clinical entity without any previous case report. Confirmatory diagnosis can be made by video electroencephalography recording of seizure activities provoked by laughing. As in gelastic seizure without hypothalamic hamartoma, our case responded well to polytherapy with topiramate and carbamazepine on top of laugh-provocation avoidance. Further study is required to establish the standard treatment of this condition.
Introduction
Laughing is an entirely human quality and a part of everyday life. Laughter has a positive effect on measures of generalized well-being. Laugh-induced seizure is an extremely rare and probably unrecognized condition and thus can easily be misdiagnosed. However, it is very important to recognize this condition as early diagnosis and treatment may control the seizure activities and improve quality of life. To the best of our knowledge, no case of laugh-induced seizure has been reported in the medical literature. Based upon our case report, we discuss the fundamentals of this condition including clinical presentation, diagnostic modalities and possible treatment options, and differentiating features with the more common condition, the gelastic seizure. Seizure activities are induced by laughter in laugh-induced seizure but laughter is the manifestation of gelastic seizure.
Source...