Pathological laughter as a presenting symptom of massive trigeminal neuromas: Report of four cases

OBJECTIVE AND IMPORTANCE: This is a report of four cases of huge trigeminal neuromas that presented with the principle symptom of pathological laughte r (PL). CLINICAL PRESENTATION: All four patients were male and were in either the t hird or fourth decade of life. In addition to PL, there were neurological d eficits related to trigeminal nerve, brainstem, and cerebellar dysfunctions . INTERVENTION: All tumors were radically excised via a lateral basal tempora l approach. The PL was cured immediately after surgery. CONCLUSION: PL sometimes precedes other neurological manifestations and may be a useful localizing sign. The clinical and radiological features in our cases suggest that PL is a result of extra-axial compression of the pens a nd adjoining neural structures.