Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of multiple sclerosis with pathological laughing caused by pontine base lesions

Yuhei Takado, M.D., Shuichi Igarashi, M.D., Yasuhisa Akaiwa, M.D., Kenshi Terajima, M.D., Keiko Tanaka, M.D. and Shoji Tsuji, M.D.

Department of Neurology, Brain Research Institute, Niigata University

We report a case of multiple sclerosis (MS) with pathological laughing for which lesions in pontine bases are considered to be responsible. A 30-year-old man was diagnosed as having MS based on left hemiparesis, and pathological laughing, and MRI findings showing a plaque in the right pontine base as well as several plaques in the bilateral periventricular deep white matter. After remission for 6 years, his pathological laughing exacerbated in association with development of right hemiparesis. A new lesion in the left pontine base was demonstrated by MRI studies in addition to a few supratentorial lesions. Steroid pulse therapy was effective for both pathological laughing and right hemiparesis. We speculate that the anatomical lesion responsible for the pathological laughing is located in the pontine base.

(CLINICA NEUROL, 42: 519|522, 2002)
key words: multiple sclerosis, pathological laughing, pontine base, MRI

(Received: 25-Jan-02)