- Syncope is a very common condition that involves a temporary loss of consciousness due to inadequate perfusion to the brain.
- The causes are multiple.
- Syncope after a spell of laughter is rare with documentation of only a few similar cases to date.
A 63-year-old man presented with a 20-year history of laughter induced syncope. His medical history was remarkable of diabetes type 2, however, controlled. He reported fainting every now and then, and that it happened at least ten times during the last twenty years. He also complained of losing consciousness after coughing.
According to his wife, most of the episodes occurred at mealtimes. Her husband would laugh spontaneously and then become unconscious for a few seconds. Moreover, the patient also added that prior to the episodes, he would experience blurring of vision and lightheadedness.
Examinations and Investigations
Physical examination of the patient did not reveal any abnormality. His ECG was normal. He did not report any muscle weakness, sleep problems or hallucinations, excluding the possibility of cataplexy. Furthermore, his Epworth Sleepiness score was 6, which is within the normal range. This ruled out any sleep disorder such as narcolepsy or irresistible sleep attacks during the daytime.
Laugh Syncope
Based on the history of the patient, his experiences are episodes of laugh syncope. It is a rare situational syncope that can only be diagnosed based on the patient’s history, physical examinations and ECG. Doctors made the diagnosis after ruling out all other possible causes of his condition.
Source: The Lancet
