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The man diagnosed with pathological laughter – BBC News

Paul Pugh was in the most critical meeting of his life. He was being told what his future would be like after receiving a brain injury in a brutal assault. He laughed the whole way through the discussion but, to him, it felt like he was sobbing. He would later be diagnosed with pathological laughter.

Pugh, now 38, had been on a night out with his Cwmaman Football Club teammates in January 2007 when he was targeted in an unprovoked attack on a cold January night.

As he left a pub in his home town of Ammanford in Carmarthenshire, west Wales, four men he didn’t know rounded on him and repeatedly punched and kicked him.

Pugh’s skull was fractured and he fell into a coma for more than two months. A blood clot which measured 10cm x 4cm formed on his brain and he was left with slurred speech, chronic fatigue and mobility difficulties which resulted in him having to use a wheelchair.

“I’ve had to learn to walk and talk again and come to terms with the fact that I will never fully recover,” he says. “Life has been a struggle for me and my family, but we’re ploughing through it.”

Pugh spent 13 months in hospital, but it wasn’t until month four that he had his first laughing fit.

“It was a serious meeting with my consultant, rehabilitation therapists and my family to discuss what my life and future was going to be like,” he says.

“When they started talking about me, I was frightened and it triggered something off in my brain and I laughed right through the meeting.

“I was actually crying my eyes out, but it came out on the surface as laughter.”

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