SUCCESSFUL TREATMENT OF GIGGLE INCONTINENCE WITH METHYLPHENIDATE

Purpose: Giggle incontinence, the second most common type of childhood enuresis unrelated to disease, is notoriously difficult to treat. How ever, the association of laughter or emotion precipitated alteration o f muscle tone is suggestive of a functional relationship to cataplexy, a part of the narcoleptic syndrome complex that may respond to stimul ant medication. Materials and Methods: Two boys and 5 girls (mean age 10.9 years) with giggle incontinence, a positive family history of gig gle incontinence (4 patients) and no evidence of urological disease we re treated with methylphenidate for 1 to 5 years. Results: All patient s responded positively with complete cessation of enuresis to varying dose schedules of methylphenidate. Conclusions: These results suggest that giggle incontinence is a centrally mediated and likely hereditary disorder that may share a common pathophysiological basis with the na rcolepsy/ cataplexy syndrome.