Brain, Vol. 116, No. 4, 757-780, 1993
© 1993 Guarantors of Brain
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Mirth, laughter and gelastic seizures
1Department of Neurology Baltimore, USA 2Epilepsy Center Baltimore, USA 3Department of Neurosurgery Baltimore, USA 4Cognitive Neurology Division Baltimore, USA 5Zanvyl Krieger Mind/Brain Institute, The Johns Hopkins University School of Medicine Baltimore, USA
Correspondence to:
Correspondence to Santiago Arroya, MD, Department of Neurology, Meyer Building 2-147, 600 North Wolfe Street, Baltimore, MD 21205, USA.
Little is known about what pathways subserve mirth and its expression laughter. We present three patients with gelastic seizures and laughter elicited by electrical stimulation of the cortex who provide some insight into the mechanisms of laughter and its emotional concomitants. The first patient had seizures manifested by laughter without a subjective feeling of mirth. Magnetic resonance imaging showed a cavernous haemangioma in the left superior mesial frontal region. Ictal subdural electrode recording showed the seizure onset to be in the left anterior cingulate gyrus. Removal of the lesion and of the seizure focus rendered the patient virtually seizure free over 16 months of follow-up. The other two patients had complex partial seizures of temporal lobe origin. Electrical stimulation of the fusiform gyrus and parahippocampal gyrus produced bursts of laughter accompanied by a feeling of mirth.
These cases reveal a high likelihood of cingulate and basal temporal cortex contribution to laughter and mirth in humans, and suggest the possibility that the anterior cingulate region is involved in the motor act of laughter, while the basal temporal cortex is involved in processing of laughter's emotional content in man.
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Received November 12, 1992. Revised March 8, 1993. Accepted April 20, 1993.
*Present address: Dr Fisher, Department of Neurology, The Barrow Neurological Institute, Phoenix, Arizona, USA
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