Pathological Laughing and Crying Associated with a Tumor Ventral to the Pons

Patho log ica l laughing and crying, defined as s u d d e n ou tburs t s of uncontrol lable, spontaneous , i napp rop r i a t e laughing a n d / o r crying, was recogn ized a n d s tudied in the late 19th century . L~'~7'22 T h o u g h mos t commonly found in diffuse cerebral vascu la r disease, it has also been observed in a v a r i e t y of infectious, degenerat ive, demyel inat ing, epi lept ic , and neoplast ic cerebral diseases. 7'13'25 Whi le repor ts of its occurrence wi th in t racranial t u m o r s have been appear ing for over half a cent u r y / '24 our case is unique in t ha t so far as we can de t e rmine , it is the first repor ted instance in which b o t h pathological laughter and crying were cured b y the removal of such a tumor. Two addi t ional cases 2~ are briefly men t ioned in which pathological laughing preceded by months or years the a p p e a r a n c e of o ther neurological signs. I n these two pa t i en t s , as in ours, the tumor was located ven t r a l to the pons. We suggest t h a t pathological l augh ing or crying may be a useful sign in the ear ly diagnosis of p re -pont ine tumors.