Editing Death from laughter (section)

== Pathophysiology ==
Laughter is normally harmless. Typically, laughter is controlled by two systems in the brain: an involuntary system that involves the [[amygdala]] and a voluntary system that involves the [[Brodmann area 44|premotor opercular]] areas.<ref>{{cite journal |last1=Wild |first1=Frank |title=Neural correlates of laughter and humour |journal=Brain |date=Oct 2003 |pages=2121–38 |doi=10.1093/brain/awg226 |url=https://pubmed.ncbi.nlm.nih.gov/12902310/ |access-date=31 January 2025}}</ref> However, death may result from several [[Pathology|pathologies]] that deviate from [[benignity|benign]] laughter. [[Infarction]] of the [[pons]] and the [[medulla oblongata]] in the brain may cause the [[pseudobulbar affect]].<ref name="Gondim">{{cite journal |vauthors=Gondim FA, Parks BJ, Cruz-Flores S |title='Fou rire prodromique' as the presentation of pontine ischaemia secondary to vertebrobasilar stenosis |journal=J Neurol Neurosurg Psychiatry |volume=71 |issue=6 |pages=802–804 |date=December 2001 |pmid=11723208 |pmc=1737630 |doi=10.1136/jnnp.71.6.802}}</ref> [[Asphyxiation]] caused by laughter leads the body to shut down from the lack of oxygen.

Laughter can cause [[atonia]] and collapse ("gelastic [[Syncope (medicine)|syncope]]"),<ref name="pmid18493621">{{cite journal |vauthors=Reiss AL, Hoeft F, Tenforde AS, Chen W, Mobbs D, Mignot EJ |title=Anomalous hypothalamic responses to humor in cataplexy |journal=PLOS ONE |volume=3 |issue=5 |pages=e2225 |year=2008 |pmid=18493621 |pmc=2377337 |doi=10.1371/journal.pone.0002225 |bibcode=2008PLoSO...3.2225R |editor1-last=Greene |editor1-first=Ernest|doi-access=free }}</ref><ref name="pmid18538031">{{cite journal |vauthors=Nishida K, Hirota SK, Tokeshi J |title=Laugh syncope as a rare sub-type of the situational syncopes: a case report |journal=J Med Case Rep |volume=2 |issue=1 |page=197 |year=2008 |pmid=18538031 |pmc=2440757 |doi=10.1186/1752-1947-2-197 |doi-access=free }}</ref><ref name="pmid14592259">{{cite journal |vauthors=Totah AR, Benbadis SR |title=Gelastic syncope mistaken for cataplexy |journal=Sleep Med. |volume=3 |issue=1 |pages=77–78 |date=January 2002 |pmid=14592259 |doi=10.1016/S1389-9457(01)00113-7 }}</ref><ref name="pmid17976409">{{cite journal |vauthors=Lo R, Cohen TJ |title=Laughter-induced syncope: no laughing matter |journal=Am. J. Med. |volume=120 |issue=11 |pages=e5 |date=November 2007 |pmid=17976409 |doi=10.1016/j.amjmed.2006.07.019|doi-access=free }}</ref> which in turn can cause trauma {{xref|(see also: [[laughter-induced syncope]], [[cataplexy]], and [[Bezold-Jarisch reflex|Bezold–Jarisch reflex]])}}. [[Gelastic seizure]]s can be due to focal [[lesion]]s to the [[hypothalamus]].<ref name="pmid18077234">{{cite journal |vauthors=Cheung CS, Parrent AG, Burneo JG |title=Gelastic seizures: not always hypothalamic hamartoma |journal=Epileptic Disord |volume=9 |issue=4 |pages=453–458 |date=December 2007 |pmid=18077234 |url=http://www.john-libbey-eurotext.fr/en/revues/medecine/epd/e-docs/00/04/37/CC/article.phtml |doi=10.1684/epd.2007.0139 |url-access=subscription }}</ref> Depending upon the size of the lesion, the [[emotional lability]] may be a sign of an acute condition, and not itself the cause of the fatality. Gelastic syncope has also been associated with the [[cerebellum]].<ref name="pmid17662020">{{cite journal |vauthors=Famularo G, Corsi FM, Minisola G, De Simone C, Nicotra GC |title=Cerebellar tumour presenting with pathological laughter and gelastic syncope |journal=Eur. J. Neurol. |volume=14 |issue=8 |pages=940–943 |date=August 2007 |pmid=17662020 |doi=10.1111/j.1468-1331.2007.01784.x|s2cid=10940256 }}</ref>