Bertolucci P H, Andrade L A, Pereira J S, De Campos C J
Arq Neuropsiquiatr. 1985 Mar;43(1):66-72. doi: 10.1590/s0004-282x1985000100010.
The authors present three cases where the involuntary, imotivated laughter was a distinct finding. The first patient was a 29-year-old engineer, who had had several bursts of neurologic deficits, either sensitive or motor, which recovered almost completely and was diagnosed as suffering from multiple sclerosis. During and after one of the episodes he presented involuntary laughter and has been like this since then, albeit in much less extension. The second patient was a 35-year-old housewife, who presented several episodes of brain infarction in both hemispheres which were considered as being the result of arteritis. No specific collagen disease was found. The CAT scan showed several hypodense areas in both hemispheres. The third patient was a 52-year-old man of Japanese ancestry who presented three years ago a sudden ischemic stroke with difficulty in the speech and left sided weakness, followed by bursts of imotivated laughter, which persisted since then. Subsequently he had another stroke. He is hypertensive and diabetic. The authors searched the literature for the different causes of involuntary laughter. The occurrence in multiple sclerosis, although reported by several authors is by no means a common finding. In the literature available no case of cerebral arteritis with involuntary laughter could be found. The pathophysiology of this rare symptom was discussed.
作者介绍了三例以不自主、无动机性发笑为显著表现的病例。首例患者是一名29岁的工程师，曾多次出现神经功能缺损发作，包括感觉或运动方面的，这些发作几乎完全恢复，被诊断为患有多发性硬化症。在其中一次发作期间及之后，他出现了不自主发笑，此后一直如此，尽管程度有所减轻。第二例患者是一名35岁的家庭主妇，双侧半球出现多次脑梗死发作，被认为是动脉炎所致。未发现特定的胶原病。计算机断层扫描显示双侧半球有多个低密度区。第三例患者是一名52岁的日裔男性，三年前突发缺血性中风，伴有言语困难和左侧肢体无力，随后出现无动机性发笑发作，此后一直持续。随后他又发生了一次中风。他患有高血压和糖尿病。作者在文献中查找了不自主发笑的不同原因。多发性硬化症中出现这种情况，尽管有几位作者报道过，但绝不是常见表现。在现有文献中，未发现伴有不自主发笑的脑动脉炎病例。本文讨论了这种罕见症状的病理生理学。
