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Pediatrie urinary infections, vesicoureteral reflux, and voiding dysfunction
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Giggle incontinence: Cause unknownUsually resolves spontaneouslyTimed voiding and anticholinergics are treatment options.
Urinary incontinence
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Giggle incontinence (enuresis risoria) is the involuntary loss of urine induced by laughter. It has been documented that giggle incontinence in 95% of children has associated dysfunctional voiding symptoms, and detrusor instability in these children contributes to the wetting. These children achieved nearly 90% remission rate within 10 weeks of being treated with timed voiding, anticholinergic medication and a bowel-management programme. Others have reported success with the use of methylphenidate (Ritalin) for the treatment of giggle incontinence.
Pharmacologic therapies for the management of non-neurogenic urinary incontinence in children
Published in Expert Opinion on Pharmacotherapy, 2019
Tiernan Middleton, Pamela Ellsworth
Giggle incontinence (GI) or enuresis risoria[84] is defined by the International Children’s Continence Society as a rare condition in which extensive leakage occurs during or immediately following laughter and bladder function are normal when there is no laughter. There are three physiologic components involved in giggle incontinence: cognition and neurologic factors, contraction of the abdominal musculature, and the combined function of the bladder detrusor and the pelvic floor muscles[85]. Those in support of a neurologic basis for giggle incontinence compare giggle incontinence to cataplexy and propose that overactive cholinergic receptors in the basal forebrain allows for excess cholinergic reuptake during an emotional response which may result in muscle atonia in the pelvic floor [85,86]. Another theory proposes that laughter incontinence is centrally mediated by an undefined neurological cascade that follows laugher that is combined with instability of the detrusor muscle resulting in incontinence and variations of this theory favor neurologic versus detrusor over activity as the primary etiology [87,88]. Reports of giggle incontinence are scarce and typically involve small numbers of patients. Some studies suggest a more frequent occurrence in females, which may be supported by a study Azim et al. which reported that men and women activate different parts of the brain when responding to humor[89].
A case of an 11-year-old girl diagnosed with OCD developing giggle incontinence following addition of aripiprazole to treatment
Published in Psychiatry and Clinical Psychopharmacology, 2018
İsmail Akaltun, Tayfun Kara, Hamza Ayaydın
Giggle incontinence (GI) is generally seen in girls and is characterized by involuntary and generally unpredictable release of urine during giggling or laughter. The amount of urine released is greater compared to stress incontinence, and the entire bladder is generally evacuated. Patients generally have no lower urinary system symptoms. The most striking characteristic is that the child is usually unable to stop the flow of urine once it has started. This rare disease is quite hard to treat, and its aetiology is still unclear [1]. The fact that methylphenidate reduces some symptoms suggests that the condition may be a cataplexy [2]. Obsessive compulsive disorder (OCD) can severely impair functioning in children and adolescents. Cognitive behavioural therapy (CBT) is the first-line treatment for the mild to moderate OCD. For moderate to severe cases, medication is indicated in addition to CBT. Selective serotonin reuptake inhibitors (SSRIs) are the first choice as drug therapy in OCD. Modification to another SSRI or to clomipramine is recommended in cases in which resistance to one SSRI is observed [3,4].