Riso imotivado: relato de três casos

Bertolucci, Paulo Henrique F.; Andrade, Luiz Augusto F.; Pereira, João Santos; Campos, Carlos José Reis de

doi:10.1590/S0004-282X1985000100010

Resumos

Os autores fazem uma revisão das causas e fisiopatologia do riso imoti-vado e de sua classificação. São apresentados três casos de riso imotivado. Um em que o distúrbio está associado a alterações motoras e sensitivas ocorrendo em crises diferentes entre si e sempre seguidas de recuperação integral, no qual foi feito o diagnóstico de esclerose múltipla. No segundo caso o riso estava associado a déficit motor e livedo reticular, tendo sido feito o diagnóstico de vasculite. No terceiro caso havia associação com paresia facial central à direita, em paciente diabético e hipertenso, com evidência de comprometimento vascular em outras áreas, tendo sido feito o diagnóstico de doença cerebrovascular.

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 hipertensive 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.

Riso imotivado: relato de três casos

Motivated laughter: report of three cases

Paulo Henrique F. Bertolucci^I; Luiz Augusto F. Andrade^II; João Santos Pereira^I; Carlos José Reis de Campos^II

^IPós-Graduando em Neurologia. Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina

^IIProfessor Adjunto-Doutor. Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina

RESUMO

Os autores fazem uma revisão das causas e fisiopatologia do riso imoti-vado e de sua classificação. São apresentados três casos de riso imotivado. Um em que o distúrbio está associado a alterações motoras e sensitivas ocorrendo em crises diferentes entre si e sempre seguidas de recuperação integral, no qual foi feito o diagnóstico de esclerose múltipla. No segundo caso o riso estava associado a déficit motor e livedo reticular, tendo sido feito o diagnóstico de vasculite. No terceiro caso havia associação com paresia facial central à direita, em paciente diabético e hipertenso, com evidência de comprometimento vascular em outras áreas, tendo sido feito o diagnóstico de doença cerebrovascular.

SUMMARY

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 hipertensive 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.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabalho realizado na Disciplina de Neurologia do Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina.

Disciplina de Neurologia, Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina - R. Botucatú, 740 - 04023, São Paulo, SP - Brasil.

1. ACHARI, A.N. & COLOVER, J, - Posterior fossa tumor with pathological laughter. J. amer. med. Assoc. 235:1469, 1976.
2. AMES, F.R. & ENDERSTEIN, O. - Ictal laughter: a case report with clinical, cinefilm and EEG observations. J. Neurol. Neurosurg. Psychiat. 38:11, 1973.
3. BLACK, D.W. - Pathological laughter: a review of the literature. J. nerv. ment. Dis. 170:67, 1982.
4. CHEN, R.C. & FORSTER, F.M. - Cursive and gelastic epilepsy. Neurology (Minneapolis) 23:1019, 1973.
5. DALY, D. & MULDER, D. - Gelastic epilepsy. Neurology (Minneapolis): 7:189, 1957.
6. DAVISON, C. & KELMAN, H. - Pathologic laughing and crying. Arch. Neurol. Psychiat. 42:595, 1939.
7. DRUCKMAN, R. & CHAO, D. - Laughter in epilepsy. Neurology (Minneapolis) 7:26, 1957.
8. GASCON, G.G. & LOMBROSCO, C.T. - Epileptic (gelastic) laughter. Epilepsia 12:63, 1971.
9. GOTTWALD, W. - Paroxysmen von pathologischen Lachen und Weinen. Med. Welt 33:622, 1982.
10. IRONSIDE, R. - Disorders of laughter due to brain lesions. Brain 79:589, 1956.
11. LEOPOLD, N.A. - Gaze-induced laughter. J. Neurol. Neurosurg. Psychiat. 40: 815, 1977.
12. LOISEAU, P.; COHADON, F. & COHADON, S. - Gelastic epilepsy - a review and report of five cases. Epilepsia 12:313, 1971.
13. MARTIN, J.P. - Fits of laughter (sham mirth) in organic cerebral disease. Brain 73:453, 1950.
14. ROSE, A.S.; ELLISON, G.W.; MYERS, L.W. & TOURTELLOTTE, W.W. Criteria for the clinical diagnosis of multiple sclerosis. Neurology (Minneapolis) 26:20, 1976.
15. SWASH, M. - Released involuntary laughter after temporal lobe infaction. J. Neurol. Neurosurg. Psychiat. 35:108, 1972.
16. SWASH, M. - Released involuntary laughter after temporal lobe infarction. J. Baltimore, 1969, pg. 216.

Datas de Publicação

Publicação nesta coleção
13 Ago 2012
Data do Fascículo
Mar 1985

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ACHARI, A.N. & COLOVER, J, - Posterior fossa tumor with pathological laughter. J. amer. med. Assoc. 235:1469, 1976.

[2] 2. AMES, F.R. & ENDERSTEIN, O. - Ictal laughter: a case report with clinical, cinefilm and EEG observations. J. Neurol. Neurosurg. Psychiat. 38:11, 1973.

[3] 3. BLACK, D.W. - Pathological laughter: a review of the literature. J. nerv. ment. Dis. 170:67, 1982.

[4] 4. CHEN, R.C. & FORSTER, F.M. - Cursive and gelastic epilepsy. Neurology (Minneapolis) 23:1019, 1973.

[5] 5. DALY, D. & MULDER, D. - Gelastic epilepsy. Neurology (Minneapolis): 7:189, 1957.

[6] 6. DAVISON, C. & KELMAN, H. - Pathologic laughing and crying. Arch. Neurol. Psychiat. 42:595, 1939.

[7] 7. DRUCKMAN, R. & CHAO, D. - Laughter in epilepsy. Neurology (Minneapolis) 7:26, 1957.

[8] 8. GASCON, G.G. & LOMBROSCO, C.T. - Epileptic (gelastic) laughter. Epilepsia 12:63, 1971.

[9] 9. GOTTWALD, W. - Paroxysmen von pathologischen Lachen und Weinen. Med. Welt 33:622, 1982.

[10] 10. IRONSIDE, R. - Disorders of laughter due to brain lesions. Brain 79:589, 1956.

[11] 11. LEOPOLD, N.A. - Gaze-induced laughter. J. Neurol. Neurosurg. Psychiat. 40: 815, 1977.

[12] 12. LOISEAU, P.; COHADON, F. & COHADON, S. - Gelastic epilepsy - a review and report of five cases. Epilepsia 12:313, 1971.

[13] 13. MARTIN, J.P. - Fits of laughter (sham mirth) in organic cerebral disease. Brain 73:453, 1950.

[14] 14. ROSE, A.S.; ELLISON, G.W.; MYERS, L.W. & TOURTELLOTTE, W.W. Criteria for the clinical diagnosis of multiple sclerosis. Neurology (Minneapolis) 26:20, 1976.

[15] 15. SWASH, M. - Released involuntary laughter after temporal lobe infaction. J. Neurol. Neurosurg. Psychiat. 35:108, 1972.

[16] 16. SWASH, M. - Released involuntary laughter after temporal lobe infarction. J. Baltimore, 1969, pg. 216.