Fall down laughing

Introduction More common in infants and young children under 2 years old, also in the neonatal period. The child often has no incentive to smile, or laughs after teasing, and at the same time, the whole body is weak, then falls to the ground, and stops laughing for half a minute, and can stand up. It can be dozens of times a day.

Cause

Common in sphingomyelinopathy (also known as Niemann-Pick disease), the majority of patients are infants and young children, is a disease caused by genetic sphingomyelinase deficiency caused by lipid metabolism disorders.

an examination

Related inspection

Brain CT examination of nervous system examination

Often manifested as hepatosplenomegaly, weight loss, anemia, growth and development and intelligent backwardness, local or general pigmentation of the skin, blue sputum visible in the lumbosacral or oral mucosa. The child often has no incentive to smile, or laughs after teasing, and at the same time, the whole body is weak, then falls to the ground, and stops laughing for half a minute, and can stand up. It can be dozens of times a day.

Differential diagnosis

The laughs caused by diseases, although in various forms, but the common feature is that the seizures of laughter and emotions are not coordinated, and they become laughs that can't be controlled and cannot be controlled. This is different from the smile of a normal person.

1. Paroxysmal laughter: Some people are subjected to certain kinds of stimuli, such as motor sounds, other people's conversations, or seeing some images on the TV screen. Although there is no ridiculous thing, it causes paroxysmal, unconscious, and not Autonomous laughter, often every half an hour, lasts for ten seconds, then stops naturally. Some people showed sudden surprise before the attack: the whole body activity was still, the eyes were gazing, the consciousness was blurred, the face was flushed, and then they giggled, sometimes even laughing in incontinence. In fact, this is a special type of seizure called paroxysmal epilepsy.

2, paroxysmal mad laugh: laughter obsessive-compulsive disorder patients often laugh for no reason, sometimes faint smiles do not show teeth, sometimes laughing mouth is not only, every hour of episodes of laughter can reach 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.

3, bitter 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 invaded the facial muscles, causing tension contraction And caused by it. Laughter is accompanied by symptoms such as tightness of the jaws, rigidity of the limbs and reversal of the horns.

4, strong laugh: some people's head (more common in the crotch), headache, vomiting, accompanied by sudden laughter, high-pitched laughter, jaw shaking, but the patient is conscious, thinking is not chaotic, response as usual.

5, smirk: This kind of laughter is seen in patients with occult depression. The inner heart is melancholy. They often smile at people, only their mouths are laughing, but their facial expressions are not happy and passionate.

6, smirking: more common in patients with cerebral arteriosclerosis, senile dementia, etc., due to the impact of intelligent barriers, although the patient is often happy, but facial expressions give people a stupid feeling.

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