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Clinicoanatomical correlates of a Fou rire prodromique in a pontine infarction
  1. FRÉDÉRIC ASSAL,
  2. NATHALIE VALENZA,
  3. THEODOR LANDIS
  1. Department of Neurology, HUG, 24 rue Micheli-du-Crest, CH-1211 Geneva, Switzerland
  2. IBCM, Faculty of Medicine, 1005 Lausanne, Switzerland
  1. Dr Frédéric Assal Frederic.Assal{at}hcuge.ch
  1. JEAN-PIERRE HORNUNG
  1. Department of Neurology, HUG, 24 rue Micheli-du-Crest, CH-1211 Geneva, Switzerland
  2. IBCM, Faculty of Medicine, 1005 Lausanne, Switzerland
  1. Dr Frédéric Assal Frederic.Assal{at}hcuge.ch

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Pathological laughter heralding a neurological deficit was first described by Ferré in 1903 as Fou rire prodromique. 1 2 We present a patient with prodromal pathological laughter and a right pontine infarction in the territory of the paramedian branch of the basilar artery. These are the first clinicoanatomical correlates integrating MRI lesion mapping with immunohistochemical studies for a serotoninergic specific enzyme of human brain stems.

Axial views at the level of the sixth nerve and the middle cerebellar peduncle in the pons. (A) MRI showing the infarct in the right ventral pons. Box area depicted in (B). (B) Micrograph of a human brainstem transverse section at the level corresponding to the MRI, immunostained for a serotonin specific enzyme. The limit of the infarct is overlayed, with respect to the reference structures: (★)=medial lemniscus; CT=corticospinal and corticobulbar tracts; MCP=medial cerebellar peduncles. (C) Enlargment of the boxed area in (B), showing the location of the raphe nucleus magnus (RMg) relative to the medial lemniscus. Scale bars: (A) 1000 μm, (B) 500 μm, (C) 250 μm.

A right handed 61 year old woman was admitted to hospital for a left hemiplegia. She presented with a history of diabetes, high …

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