[The Pilgaard-Dahl syndrome: laughter-induced pneumothorax].

Hæmatologisk/onkologisk Afdeling, Roskilde Sygehus, 4000 Roskilde, Denmark.
Ugeskrift for laeger 12/2010; 172(50):3496-8.
Source: PubMed


In this article we propose the eponym Pilgaard-Dahl syndrome (named after two Danish revue actors). The syndrome consists of laughter-induced pneumothorax in smoking middle-aged men when exposed to hearty humour. The epidemiology and pathophysiology of spontaneous pneumothorax - in particular the Pilgaard-Dahl syndrome - is described. Finally, the occurrence of other detrimental effects of laughter as syncope, extreme bradycardia, asthma bouts, headache, stroke, death, and incontinence are described, as well as initiatives expected to minimise the occurrence of good mood are proposed.

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    ABSTRACT: To review the beneficial and harmful effects of laughter. Narrative synthesis. We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category. Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration. However, laughter is no joke-dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman's syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease. Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny.
    BMJ (online) 12/2013; 347(dec12 3):f7274. DOI:10.1136/bmj.f7274 · 17.45 Impact Factor