CLIVAL CHORDOMA ASSOCIATED WITH PATHOLOGICAL LAUGHTER - CASE-REPORT

The case of a 40-year-old man with a clival chordoma who presented wit h symptoms of pathological laughter and left sixth cranial nerve pares is is reported. Laughing and talking during sleep were noted on polygr aphic and videotape recordings of nocturnal sleep. Selective disorgani zation of sleep was observed, with laughing facial expressions and a l ack of muscular atonia. The tumor developed in the prepontine cistern, compressing the pontomesencephalic structures backward and involving the upper clivus and the left cavernous sinus. No recurrence of laught er attacks were noted after total removal of the tumor. The sleep patt erns observed were similar to those of experimental animals with lesio ns of the peri-alpha locus ceruleus. The importance of uncontrolled la ughter as a sign of a ventral brain-stem mass is emphasized.