Pathological laughter in a patient with trigeminal neurinoma.
We present a 47-year-old woman with a long history of anxiety and a more recent history of shock-like facial pain and episodes of laughter without any motivation. She could not explain the laughing bursts and did not have a sense of mirth preceding it. On neurological examination she presented a VI nerve palsy and trigeminal hypoesthesia (V2 and V3) on the right side. Magnetic resonance imaging exhibited a large cystic lesion on the right middle fossa causing significant compression on the brain stem. A frontoorbitozygomatic and pretemporal combined approach was performed. During intra and extradural exploration a large tumor was found on the trigeminal nerve. The whole lesion was resected, revealing to be a neurinoma on pathological exhamination. She maintained a VI nerve palsy but had complete remission of the unmotivated laughing episodes during the one year follow up.
Machado
André G
AG
Division of Neurosurgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, SP, Brazil. aggmachado@yahoo.com
Aguiar
Paulo Henrique
PH
Marino
Raul
R
D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D007845:Laughter; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D020433:Trigeminal Nerve Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery