One woman, a 34-year-old whose daily “giggling attacks” began at age 4, described the symptom as a “tickling inside my head” that could be suppressed. By age 25, these episodes would sometimes be followed by a seizure. Drugs have reduced seizure frequency, but the woman still has 10- to 15-second bouts of suppressed giggling up to 10 times daily.
A 25-year-old man whose laughing episodes began when he was a baby said he could contain the giggles by biting his lip. He told the doctors the pressure-to-laugh feeling was “pleasant and made him feel happy.” When he did allow himself to laugh — in a “socially appropriate situation” — his face reddened and his eyes watered. The giggly feeling, however, caused no red face or teary eyes.
What’s behind this generally pleasant symptom is unclear, according to Berkovic and his colleagues. Unlike many cases of hypothalamic hamartoma, all three patients had normal brain development and no behavioral problems. The Australian neurologists advise doctors treating patients with unexplained giggling bouts not to assume that the problem is always psychological, but to send these patients for brain scans to rule out hypothalamic hamartoma as a cause of the fits of laughter.
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