A survey about laughter upon viewing functional seizures

Authors

• Mohamad Z. Koubeissi, Department of Neurology, The George Washington University, Washington, DC, United States.
• Nadim Jaafar, Department of Neurology, The George Washington University, Washington, DC, United States.
• Christopher Saouda, Department of Neurology, The George Washington University, Washington, DC, United States.
• Alexandra Eid, Department of Neurology, The George Washington University, Washington, DC, United States.
• W Curt LaFrance, Departments of Neurology and Psychiatry, Comprehensive Epilepsy Program, Rhode Island Hospital, Brown Medical School, Providence, RI, United States.
• Gülşen Öztosun, Department of Neurology, The George Washington University, Washington, DC, United States.
• Hassna S. Aziz, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
• Muhammad T. Khan, Charleston Area Medical Center, Charleston, WV, United States.
• Faraaz A. Khan, Ross University School of Medicine, Miramar, FL, United States.
• Adam U. Syed, University of Toledo Health Science Campus, Toledo, OH, United States.
• Adam Khalil, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States.
• Candan Gürses, Koç University Hospital, Istanbul, Türkiye.
• Tanvir U. Syed, Access Telecare, Dallas, TX, United States.

Document Type

Journal Article

Publication Date

1-1-2026

Journal

Frontiers in neurology

Volume

17

DOI

10.3389/fneur.2026.1725833

Keywords

behavior; clinical practice; functional seizures; laughter; nonepileptic seizures

Abstract

INTRODUCTION: Laughter among physicians when observing clinical manifestations of functional seizures (FS) or other functional disorders is frequently noted. This reflexive response can occur both in clinical practice and during video presentations at medical conferences. We examine the underlying factors contributing to physicians' laughter in response to the diagnosis of FS. METHODS: The research, spanning 5 years and diverse geographical locations, surveyed 221 participants, including physicians and non-physicians, to understand the reasons behind laughter during FS diagnoses. RESULTS: A total of 221 respondents (estimated 20-25% of attendees) completed the survey, with 56% identifying as physicians and 44% as non-physicians. Observational data showed laughter responses to FS videos varied widely across settings: approximately 57% at U. S. medical grand rounds, compared to 5-17% at international conferences, and 0% among non-medical audiences. Survey analysis revealed 10 thematic categories for reasons behind laughter, with significant differences between physicians and non-physicians. Non-physicians more frequently cited defense mechanisms, negative opinions, and ignorance, whereas physicians more often attributed laughter to superiority, diagnostic skepticism, or perceived patient deception. U. S. physicians were significantly more likely than non-U. S. physicians to report discomfort, negative opinions, and ignorance. No significant differences were found between neurologists and internists. SIGNIFICANCE: Laughter may serve multifaceted adaptive functions in response to the complexities of diagnosing and managing patients with FS. By highlighting misperceptions surrounding functional disorders, the study underscores the importance of fostering a deeper understanding among clinicians to ensure equitable care for patients experiencing FS.

APA Citation

Koubeissi, Mohamad Z.; Jaafar, Nadim; Saouda, Christopher; Eid, Alexandra; LaFrance, W Curt; Öztosun, Gülşen; Aziz, Hassna S.; Khan, Muhammad T.; Khan, Faraaz A.; Syed, Adam U.; Khalil, Adam; Gürses, Candan; and Syed, Tanvir U., "A survey about laughter upon viewing functional seizures" (2026). GW Authored Works. Paper 8752.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8752

Department

Neurology