From the *Service de Biophysique et Médecine Nucléaire and †Unité Neuro-vasculaire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ‡Université de Strasbourg, EA 3072, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; and §ICube, Université de Strasbourg/CNRS (UMR 7357), Strasbourg, France.
Clin Nucl Med. 2015 Sep;40(9):734-6. doi: 10.1097/RLU.0000000000000809.
We present the case of a 40-year-old man consulting for uncontrollable episodes of laughing related to emotional lability and not systematically linked to feelings of happiness. Seven months earlier he had presented a pontine ischemic stroke related to an occlusion of the basilar and left vertebral arteries. No epileptic activity or new MRI brain lesions were found. Brain perfusion SPECT performed showed marked hypoperfusion in the right frontal inferior and temporoinsular regions, suggesting a diaschisis phenomenon caused by pontine lesions and highlighted laughing regulation pathways. The patient was successfully treated with a serotonergic reuptake inhibitor, fluoxetine.
我们报告了一例 40 岁男性，因情绪不稳定导致无法控制的大笑而就诊，且这些大笑并非与幸福感系统相关。七个月前，他曾因基底动脉和左侧椎动脉闭塞而出现桥脑缺血性卒中。未发现癫痫活动或新的脑部 MRI 病变。进行的脑灌注 SPECT 显示右侧额下回和颞岛叶区域明显灌注不足，提示桥脑病变引起的去传入现象，并突出了大笑调节通路。该患者使用 5-羟色胺再摄取抑制剂氟西汀成功治疗。
