Cerebellar tumour presenting with pathological laughter and gelastic syncope

• Published in: European journal of neurology Vol. 14; no. 8; pp. 940 - 943
• Main Authors: Famularo, G., Corsi, F. M., Minisola, G., De Simone, C., Nicotra, G. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2007
• Subjects: Affective Symptoms - etiology; Affective Symptoms - pathology; Affective Symptoms - physiopathology; Brain Stem - physiopathology; Cerebellar Neoplasms - complications; Cerebellar Neoplasms - pathology; Cerebellar Neoplasms - physiopathology; cerebellum; Cerebellum - pathology; ependymoma; Ependymoma - complications; Ependymoma - pathology; Ependymoma - physiopathology; Fourth Ventricle - pathology; gelastic syncope; Humans; Laughter; Male; Middle Aged; Neural Pathways - physiopathology; Neurosurgical Procedures; pathological laughter; Syncope - etiology; Syncope - pathology; Syncope - physiopathology; Treatment Outcome; Unconsciousness - etiology; Unconsciousness - pathology; Unconsciousness - physiopathology
• ISSN: 1351-5101; 1468-1331; 1471-0552
• DOI: 10.1111/j.1468-1331.2007.01784.x

There is no report of patients in whom pathological laughter, a rare condition characterized by uncontrollable episodes of laughter usually triggered by unrelated stimuli, was ever closely associated with a loss of consciousness overtly linked with the onset of such uncontrollable laughter, also referred to as a gelastic syncope. A 53‐year‐old man presented with a 4‐month history of syncope following intense and uncoordinated laughter. Physical and neurological examination was normal and the patient had no other typical cerebellar signs. We found a mass in the cerebellar vermis abutting the floor of the fourth ventricle, which upon histological examination after surgery proved to be an ependymoma. We emphasize that pathological laughter and gelastic syncope could represent unique and sole features of a cerebellar disorder.