[Transitory episode of laughter as the initial symptom of an ischemic stroke].

BACKGROUND

Pathological laughter occurs in pseudobulbar paralysis, in psychiatric disorders and as a sign of convulsions (gelastic crisis). An extremely rare form is the "fou rire prodromique' a pathological episode of laughter preceding a stroke. The pathogenesis is unknown and classically differentiated from gelastic crises. "Fou rire prodromique' has been described in subcortical ischaemic or haemorrhagic strokes, not in cortical strokes.

METHODS

We describe a patient with an ischaemic cerebrovascular accident due to embolism of the left Sylvian artery. The clinical picture started with a short episode of pathological laughter which preceded sensitive aphasia and weakness of the right limbs.

CONCLUSIONS

We suggest that in the case described it is impossible to differentiate between the "fou rire prodromique' and a gelastic crisis as a first sign of an embolic cerebrovascular accident.