Laughing at funerals

Abstract

### Learning Point for Clinicians Ischaemic strokes are a cause of pathological laughter (PL). PL can be an acute or delayed presentation of strokes. Several neuroanatomical sites have been implicated in PL. PL can be mood incongruent or it can be exaggeration of a normal response. As with action and cognition, acute disturbance of emotional expression should also be recognized as having a neural basis. Serotonin reuptake inhibitors have been used in the management of delayed-onset PL after strokes. A 58-year-old man was referred to clinic with a complaint of episodic laughter. He had been playing charades with his family at Christmas when he found himself unable to continue owing to uncontrollable laughter. Though the game had been lively, nothing especially amusing had occurred. He thought little of it, until the episode recurred at a funeral, where he laughed throughout the service without any cause, and was profoundly embarrassed. The most recent episode was while visiting …