Background: Four rire prodromique, described as pathological laughter preceding the onset of an apoplectic attack, is a rare phenomenon.
Case description: A 61-year-old man manifested pathological laughter before a sudden right hemiplegia. MRI showed a left lenticular and caudate nucleus infarct with involvement of the external capsule and prerolandic area. MRA revealed a left internal carotid and middle cerebral artery occlusion.
Conclusions: The clinicoanatomic correlates of this phenomenon are discussed.