A rare case of a diffuse intrinsic pontine glioma presenting as pathological laughter and apparent hyperactivity in a child

Introduction: Diffuse intrinsic pontine gliomas generally present with cranial nerve palsies with cerebellar and pyramidal-tract involvement. The pons has generally not been regarded as a structure that mediates complex affective behaviour. However pathological laughter has been reported with pontine pathology in various forms. 

 

Case Presentation: We present a case of pontine glioma presenting as pathological laughter and apparent hyperactivity in a previously healthy 11-year-old boy.

 

Discussion: Literature states that pontine gliomas are the subgroup of brainstem gliomas with the worst prognosis. This patient remained with deficits in motor functions and coordination despite intense treatment with radiotherapy.