An Electro-clinical Study of Ictal Laughter

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  • 発作性笑い
  • 脳波・ビデオ同時記録された8症例
  • Eight Cases Analysed by Video-EEG Documentation

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Abstract

A total of 19 episodes of epileptic laughter in 8 patients were documented by video-EEG recording. The patients were classified into two groups: 4 patients having complex partial seizures (cps) of frontal origin (group F) and 4 patients with cps of temporal origin (group T). In group F, laughter was associated with peculiar automatism characterized by a bout of vigorous struggling of the extremities and body axis (frontal automatism).The laughter ended abruptly in group F. In group T, laughter was accompanied by rather mild gestural automatism, which usually tapered off toward the end of the seizure. In both groups, the laughter began in the first half of the seizure, suggesting that the laughter was an ictal phenomenon related to the seizure origin. The laterality of seizure onset was confirmed in 6 patients; 2 in group T and 4 in gruop F. The seizures originated from the left hemisphere in 4 patients and the right in 2. In 3 patients in group F, cranial CT scans revealed organic lesions in the left hemisphere. None of these patients was able to recall a feeling of mirth associated with the laughter, indicating that the ictal laughter was merely a facial expression without accompanying emotional change in all patients.However, there is a possibility that an ictal feeling of mirth may have been experienced in group T, since all the patients in this group had ictal amnesia.

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