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June 15, 2005

Shear Hilarity Leading to Laugh Syncope in a Healthy Man

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(23):2859-2864. doi:10.1001/jama.293.23.2863-b

To the Editor: Although syncope resulting from laughter has been described in a patient with extensive underlying arteriovascular disease,1 we are unaware of any published reports of laugh syncope in an apparently healthy person.

Case Report

At 4 PM on a March day, a 32-year-old, previously healthy barber was standing and cutting a client’s hair. The client related a funny story, upon which the barber broke out into a very strong, sustained, loud, and unrestrained laughing fit during which, according to observers, he “blacked out” and fell to the floor. Although he sustained interscapular bruising and minor trauma to the right shoulder, he exhibited no seizure activity and no bladder or bowel incontinence. He regained consciousness within a few seconds, was completely oriented, had no apparent neurological deficit, and immediately resumed his work. He had been working on his feet throughout the day, but this was customary for him and he had never had a syncopal or near-syncopal episode before. The temperature at the time had been mild. The timing of his most recent meal was not recorded. The patient did not reveal the content of the story.

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