The laughing headache

In many patients, laughing can trigger a secondary cough headache. Some in the medical community also designate this situation as a “laughing headache.” A February 2022 paper (1)  in the journal Cureus presented a case of a young student whose laughing triggered his headaches. During these headaches, the student had normal brain imaging.  The proposed pathophysiology in this case could be loud laugh induced Valsalva maneuver (pushing air out against a closed airway, like holding your nose to clear your ears) raising intra-abdominal and intra-thoracic pressure momentarily causing venous congestion (blood backed up in the veins) of head presenting as episodic headache.  . .Momentarily rise of intracranial pressure due to vigorous laugh could press the tonsils or distal cerebellar portion to herniate down transiently, causing symptoms and may be back to normal position once the laugh ceases.

We are going to look at a 2017 study in the journal Headache (2) to look for other causes of the secondary cough headache and show similarities with and possible triggers caused by laughter. Here are the learning points of this paper:

• “Laughing is a rare precipitating factor for headaches, and the pathogenesis underlying laugh-induced headache remains unclear.”

Next, the researchers presented two case histories:

• In the first patient, magnetic resonance imaging of the brain revealed cerebellar tonsillar herniation through the foramen magnum.
• In the second patient, we did not find any evidence of intracranial disease.

Now here is the challenge:

• Changes in the spatial structure in the posterior cranial fossa and cerebrospinal fluid circulation may contribute to the development of secondary laugher headaches with shared similarities with the cough headache

Here again, we have doctors speculating on possible connections because the connections in many cases are not clear and are wrapped in complexity. Let’s examine the problem of cerebrospinal fluid circulation. I will present here a summary of my more extensive article: Cervical Spine Instability, Vein blockage, fluid build up, and intracranial hypertension.

We see many patients who have a serious health challenge in having intracranial hypertension. In many of these people, intracranial hypertension was not initially thought of as a primary problem as their doctors instead tackled the symptoms that these people were facing. Symptoms included dizziness, headache, vision problems such as sensitivity to light where exaggerated pupillary hippus dilating and constricting which can cause problems with light sensitivity and the pupil fails to respond correctly to light sources. These people also faced symptoms and diagnosis of Tinnitus or ringing in the ears, neck pain, and tremors.

Once a problem of intracranial hypertension or a  build-up of pressure around the brain was discovered, a myriad of tests and treatments were tried. Once obvious causes such as head injury or stroke were ruled out, initial testing may have looked for causes in blood clots, infection, and tumors. Once tests ruled those out as causes your diagnosis of intracranial hypertension, you then got an updated diagnosis of idiopathic intracranial hypertension, which means no one knows why you have intracranial hypertension.

Summary and contact us. Can we help you? How do I know if I’m a good candidate?

We hope you found this article informative and it helped answer many of the questions. Just like you, we want to make sure you are a good fit for our clinic prior to accepting your case. While our mission is to help as many people with chronic pain as we can, sadly, we cannot accept all cases. We have a multi-step process so our team can really get to know you and your case to ensure that it sounds like you are a good fit for the unique testing and treatments that we offer here.

Please visit our contact page!

1 Daripa B, Lucchese S. Laugh Headache, Not a Joke! A Case Report. Cureus. 2022 Feb;14(2). [Google Scholar]
2 Ran Y, Liu H, Zhang M, Dong Z, Yu S. Laugh‐Induced Headache: Clinical Features and Literature Review. Headache: The Journal of Head and Face Pain. 2017 Nov;57(10):1498-506. [Google Scholar]

Reviewed February 8, 2025