  {"id":106502,"date":"2019-11-19T10:05:06","date_gmt":"2019-11-19T20:05:06","guid":{"rendered":"https:\/\/www.hawaii.edu\/news\/?p=106502"},"modified":"2020-03-13T14:23:51","modified_gmt":"2020-03-14T00:23:51","slug":"cure-for-uncontrollable-laughter","status":"publish","type":"post","link":"https:\/\/www.hawaii.edu\/news\/2019\/11\/19\/cure-for-uncontrollable-laughter\/","title":{"rendered":"<abbr title=\"东精影业\">东精影业<\/abbr> doctors find a cure for uncontrollable laughter"},"content":{"rendered":"<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Reading time: <\/span> <span class=\"rt-time\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><figure id=\"attachment_106418\" aria-describedby=\"caption-attachment-106418\" style=\"width: 676px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-laughter-illustration.jpg\" alt=\"illustration of man in case study\" width=\"676\" height=\"381\" class=\"size-full wp-image-106418\" srcset=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-laughter-illustration.jpg 676w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-laughter-illustration-300x169.jpg 300w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-laughter-illustration-130x73.jpg 130w\" sizes=\"auto, (max-width: 676px) 100vw, 676px\" \/><figcaption id=\"caption-attachment-106418\" class=\"wp-caption-text\">Illustration by <abbr title=\"John A. Burns School of Medicine\">JABSOM<\/abbr> 2nd year medical student Christina Tse.<\/figcaption><\/figure>\n<p>Laughter is good medicine, except when it actually <strong>is<\/strong> <em>the<\/em> symptom of an illness. Medical residents at the University of <span aria-label=\"Hawaii\">Hawai&#699;i<\/span> at M\u0101noa <a href=\"http:\/\/jabsom.hawaii.edu\">John A. Burns School of Medicine<\/a> (<abbr>JABSOM<\/abbr>) helped a man who suffered from nearly a lifelong affliction that caused him to laugh with no control over when it happened or why.<\/p>\n<p>&ldquo;This was a very medically intriguing case. Prior to this case, I didn\u2019t know seizures could manifest in such a way as uncontrollable laughter,&rdquo; said <strong>Nina Leialoha Beckwith<\/strong>, a family medicine resident at <abbr>JABSOM<\/abbr> who worked on the case with fellow residents under the supervision of <abbr>JABSOM<\/abbr> clinical professor <strong>Kore Kai Liow<\/strong>, neurologist and chief of staff-elect at <a href=\"https:\/\/www.adventisthealth.org\/castle\/\">Adventist Health Castle<\/a>.<\/p>\n<p>The case was academically compelling but also stirred great empathy in the physician trainees. The patient, 40 years old at the time, had suffered from the uncontrolled laughter since the age of eight.<\/p>\n<div style=\"float:right;clear:right;margin:0 0 0 15px;\"><figure id=\"attachment_106420\" aria-describedby=\"caption-attachment-106420\" style=\"width: 214px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-liow-kore-214x300.jpg\" alt=\"Kore Kai Liow\" width=\"214\" height=\"300\" class=\"size-medium wp-image-106420\" srcset=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-liow-kore-214x300.jpg 214w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-liow-kore-93x130.jpg 93w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-liow-kore.jpg 250w\" sizes=\"auto, (max-width: 214px) 100vw, 214px\" \/><figcaption id=\"caption-attachment-106420\" class=\"wp-caption-text\">Kore Kai Liow<\/figcaption><\/figure><\/div>\n<div style=\"float:right;clear:right;margin:0 0 0 15px;\"><figure id=\"attachment_106417\" aria-describedby=\"caption-attachment-106417\" style=\"width: 214px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-beckwith-nina-214x300.jpg\" alt=\"Nina Beckwith\" width=\"214\" height=\"300\" class=\"size-medium wp-image-106417\" srcset=\"https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-beckwith-nina-214x300.jpg 214w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-beckwith-nina-93x130.jpg 93w, https:\/\/www.hawaii.edu\/news\/wp-content\/uploads\/2019\/11\/manoa-jabsom-beckwith-nina.jpg 250w\" sizes=\"auto, (max-width: 214px) 100vw, 214px\" \/><figcaption id=\"caption-attachment-106417\" class=\"wp-caption-text\">Nina Beckwith<\/figcaption><\/figure><\/div>\n<p>&ldquo;I believe his story can help us as clinicians to identify and provide better care for patients suffering from similar conditions,&rdquo; said Beckwith. &ldquo;I can only imagine what it is like for this patient to suffer from these bizarre seizures for so many years. I\u2019m grateful to have been a part of his care.&rdquo;<\/p>\n<h2>A rare form of epilepsy<\/h2>\n<p>As the physicians reported in the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30533284\"><em><span aria-label=\"Hawaii\">Hawai&#699;i<\/span> Journal of Medicine and Social Welfare<\/em><\/a>, the medical term for the condition was a gelastic seizure. They wrote, &ldquo;Gelastic seizures (<abbr>GS<\/abbr>) are a rare form of epilepsy characterized by inappropriate, uncontrolled laughter. They are highly associated with abnormal cognitive development and behavioral problems in patients. Research has shown that GS can originate from,&rdquo; non-cancerous tumors on the hypothalamus region of the brain. &ldquo;GS have also been observed in patients with frontal and temporal lobe lesions.&rdquo;<\/p>\n<p>The man had a history of both a brain tumor and of diabetes mellitus and schizophrenia, in addition to the laughing fits, which struck two to three times a week. He had been considered by some to have longstanding behavioral issues. But when it came to the uncontrolled laughter, there was indeed a physical cause, and when the hypothalamic hamartoma was detected and the patient treated with medicine, the laughter was brought under control, according to Liow.<\/p>\n<p>The researchers concluded that gelastic seizures need to be included in diagnosing patients with uncontrolled laughter. They wrote, &ldquo;Thus, a thorough workup should include neuroimaging with attention to the suprasellar region and <abbr>EEG<\/abbr> or electroencephalogram. Accurate, early diagnosis and patient education are critical in avoiding excessive and unnecessary treatments.&rdquo; <\/p>\n<p>Learn more about this case on the <a href=\"https:\/\/jabsom.hawaii.edu\/laughter-that-needed-a-cure-how-a-uh-medical-professor-and-his-physician-trainees-helped-solve-a-mystery-tormenting-a-patient-for-three-decades\/\">JABSOM website<\/a>. <\/p>\n<p><em>&#8212;By Tina Shelton<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medical residents at the John A. Burns School of Medicine helped a man who suffered from nearly a lifelong affliction that caused him to laugh with no control over when it happened or why.<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[31,1363,1011,9],"class_list":["post-106502","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research","tag-john-a-burns-school-of-medicine","tag-manoa-research","tag-neurology","tag-uh-manoa","entry","has-media"],"aioseo_notices":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/106502","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/comments?post=106502"}],"version-history":[{"count":11,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/106502\/revisions"}],"predecessor-version":[{"id":113666,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/posts\/106502\/revisions\/113666"}],"wp:attachment":[{"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/media?parent=106502"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/categories?post=106502"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hawaii.edu\/news\/wp-json\/wp\/v2\/tags?post=106502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}