Tickling the Brain: The Pathophysiology of Pathological Laughter

In this presentation, Dr. Atul Maheshwari discusses the developmental and evolutionary origins of laughter, and highlights the key neuroanatomical circuits involved in different types of laughter. In addition, he describes the characteristics of neural lesions that generate instances of pathological laughter and crying, including gelastic seizures.
This Neurology Grand Rounds session took place on Friday, April 10, 2026 at 12:00 p.m.

Activity Information

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Needs Statement

Learners require targeted education that increases their knowledge of current evidence-based guidelines and enhances their competence in applying new diagnostic and therapeutic approaches to neurological diseases. Subspecialist-led sessions on neurological testing and disease management can help participants understand the latest advances in migraine pharmacology, acute and preventive stroke strategies, and the integration of comorbidity management into neurological care. The educational activities of this series will focus on translating guideline recommendations into clinical decision-making, improving the ability to assess and manage patients using up-to-date techniques, and fostering the implementation of a wide spectrum of therapeutic interventions based on the latest evidence.

Educational Objectives

At the conclusion of the activity, participants should be able to:

  • Examine the underlying purpose of laughter and its developmental and evolutionary origins.
  • Evaluate the key neuroanatomical circuits involved in the generation of volitional and emotional laughter.
  • Appraise lesions that lead to pathological laughter and crying.

Target Audience

Professional Categories

  • Physicians
  • Medical Students
  • Fellows
  • Residents
  • Other Health Professionals

Specialties

  • Neurology

Interest Groups

Activity Evaluation

Evaluation by questionnaire will address program content, presentation, and possible bias.

Educational Methods

  • Lectures

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Activity Director

  1. Jacob Mandel, M.D.

    Jacob Mandel, M.D.

    Assistant Professor
    Baylor College of Medicine

Term of Approval

April 1, 2026 through April 30, 2028. Original release date: April 1, 2026.

Disclosure Policy

Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.

In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.

In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.

BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.

All of the relevant financial relationships listed for these individuals have been mitigated.

Disclosures

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Presenter

  1. Atul Maheshwari, M.D.

    Atul Maheshwari, M.D.

    Associate Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

Activity Director

  1. Jacob Mandel, M.D.

    Jacob Mandel, M.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

Planning Committee Members

  1. Sarah Berth, M.D., Ph.D.

    Sarah Berth, M.D., Ph.D.

    Assistant Professor of Neurology, Director of ALS Clinical Trials Unit; Adjunct Assistant Professor of Neurology
    Baylor College of Medicine; Johns Hopkins University School of Medicine (Baltimore, Maryland)

    Disclosure:
    • Research Support: Cellenkos (current)
  2. Corey Goldsmith, M.D.

    Corey Goldsmith, M.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:
    • Intellectual Property (patent rights, royalty payments): Elsevier Publishing (royalty payments)
  3. George Joseph Hutton, M.D.

    George Joseph Hutton, M.D.

    Professor
    Baylor College of Medicine

    Disclosure:
    • Research Support: Genentech; Genzyme; Horizon; Novartis; TGTherapeutics; Sanofi
    • Consultancy: Novartis (ended)
    • Advisory Committee Membership: Autoimmunity BioSolutions, Inc.
  4. Doris Hichi Kung, D.O.

    Doris Hichi Kung, D.O.

    Associate Professor
    Baylor College of Medicine

    Disclosure:
    • Consultancy: Aquifer (current)
  5. Jacob Mandel, M.D.

    Jacob Mandel, M.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  6. Michael Moore, M.D.

    Michael Moore, M.D.

    Assistant Professor, Neurology
    Baylor College of Medicine

    Disclosure:
    • Research Support: Alexion Pharmaceuticals (current)

Presenter:

Atul Maheshwari, M.D.

Atul Maheshwari, M.D.

Associate Professor Baylor College of Medicine

Health Topics

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