Forced laugh

Introduction It is a kind of laugh that can't be restrained. The sudden laughter is not endless, the laughter is high, but the patient is conscious, the mind is not chaotic, and the response is as usual. This sick smile is called a strong laugh. The more consistent performance of strong crying and laughing is that the patients mood is basically normal for most of the time, but under very slight or irrelevant incentives (such as removing the bed cover or someone walking towards the patient), the patient is unpredictable. The crying and laughing that cannot be controlled and adjusted autonomously. The performance of each episode is more stereotyped or fixed (no change in the degree of crying, duration, etc.), and cannot reflect or change the mood of the patient at that time. After a few minutes of excessive, uncontrollable crying and laughing, the patient returns to the basic emotional state. When asked about the feelings of the episode, the patient expressed no grief, anxiety, happiness or any subjective emotional experience. This kind of separation between the subjective feelings and the emotional expressions of crying but not feeling sad, laughing but not happy is a key feature of "strong crying and laughing".

Cause

More common in elderly patients with diffuse cerebral arteriosclerosis and other brain organic lesions, cranial trauma, brain tumors, etc. can also be caused.

an examination

Related inspection

Brain CT examination blood routine

The sudden laughter is not over, the laughter is high, the jaw is shaking, but the patient is conscious, the mind is not chaotic, and the response is as usual. With headache, vomiting.

Many patients have both crying and laughing. When a small number of patients only have one type, pathological crying is more common than laughing.

Differential diagnosis

Paroxysmal smirk: manifested as paroxysmal inability to laugh spontaneously, many people attack several times to dozens of times a day, from a few days to several weeks, each episode lasts tens of seconds to several minutes, is a laugh Characteristics of sexual epilepsy. In addition to laughter, the disease is often accompanied by ADHD, EEG changes (indefinite duration) and varying degrees of disturbance of consciousness.

Paroxysmal laughter: Laughing obsessive-compulsive disorder patients often laugh for no reason, sometimes faint laughter does not show teeth, sometimes laughs more than mouth, every hour of episodes of laughter can be more than 10 times, each lasting 5-6 seconds. In the early stages of the disease, people often sneak a laugh, and gradually become more and more difficult to control. No matter when and when, or laughing or smiling, there is no scruples. This is a special psychiatric disorder caused by the coordination of the nervous system's excitation and inhibition processes. The unstable excitatory process causes the cerebral cortex to form a stubborn stagnant and inert excitatory lesion.

Wry smile: common in tetanus patients, this laugh is not from the patient's heart, but a destructive pathological manifestation, because the sputum toxin secreted by tetanus bacillus first invades the facial muscles, causing it to contraction. of. Laughter is accompanied by symptoms such as tightness of the jaws, rigidity of the limbs and reversal of the horns.

Smirk: This kind of laughter is seen in patients with occult depression. The inner heart is melancholy, and often smiles at people. Only the mouth is laughing, but the facial expression is not happy and passionate.

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