Death may result from several pathologies that deviate from benign laughter.

Infarction of the pons and medulla oblongata in the brain may cause pathological laughter.

Laughter can cause atonia and collapse ("gelastic syncope"), which in turn can cause trauma.

Gelastic seizures can be due to focal lesions to the hypothalamus Depending upon the size of the lesion, the emotional lability may be a sign of an acute condition, and not itself the cause of the fatality. Gelastic syncope has also been associated with the cerebellum.

In popular culture

In the third century B.C. the Greek stoic philosopher Chrysippus died of laughter after giving his donkey wine, then seeing it attempt to feed on figs.
Martin I of Aragon died from a lethal combination of indigestion and uncontrollable laughing in 1410.
Pietro Aretino, who died in 1556, "is said to have died of suffocation from laughing too much."
It is cited that the Burmese king Nanda Bayin, in 1599 "laughed to death when informed by a visiting Italian merchant that Venice was a free state without a king."In 1660, the Scottish aristocrat, polymath and first translator of Rabelais into English, Thomas Urquhart, is said to have died laughing upon hearing that Charles II had taken the throne.

In popular culture
In Seinfeld, Jerry performs his comedy act for a hospitalized friend, who then proceeds to die laughing.
In Sarah Ruhl's Pulitzer-finalist play The Clean House, the character Ana dies after hearing "the worlds funniest joke" from the character Matilde.
In Robert Zemeckis's 1988 movie Who Framed Roger Rabbit, the weasels hired to catch the eponymous character have to be reminded repeatedly not to laugh, at the risk of dying from laughter. Eventually protagonist Eddie Valiant (Bob Hoskins) does kill them all with an elaborate comic routine during the film's climax.
The Batman villain The Joker sometimes uses gas or poisons which induces his victims to laugh to death.
In the film Mary Poppins the president of the bank, Mr. Dawes Sr., dies while laughing hysterically at a joke told by Mr. Banks.
In the first episode of the television series Monty Python's Flying Circus in 1969 and in the 1971 film And Now For Something Completely Different there is a sketch entitled "The Funniest Joke In The World" in which a humorist writes a joke so funny that he and everyone else who reads it laughs themselves to death. It is eventually translated into German and used as a weapon against the Nazis with devastating effect. It is stated that the joke is worked on one word at a time to prevent the translators from dying themselves. "One of them saw two words of the joke and spent several weeks in hospital." The Germans retaliate with a "V-Joke" but it fails to have any effect. After peace breaks out and the war ends, joke warfare is banned by the Geneva Convention.
A character in the novel The Westing Game tells a story of a wise man who predicts the day of his own death. As midnight approaches, the man realizes that he has survived the day and begins to laugh. Finally, at one minute before midnight, he dies laughing.
In South Park episode Scott Tenorman Must Die, Kenny McCormick laughs himself to death after seeing the I'm A Little Piggy video.
In the film The Tune it depicts the Lovesick Hotel where all the guests are there to commit suicide. One of the rooms is the "Laugh Yourself to Death" room, where someone is shown dying from laughter watching a clown hit himself in the face with a fish.
On an episode of 1000 Ways to Die one of the deaths portrays a man obsessed with jokes being told a joke that triggers a 36 hour attack of uncontrollable laughter, eventually having a cardiac arrest. In Daffy Duck's Quackbusters, Daffy attempts to win a money prize by making the rich "JP Cubish" laugh, eventually dying from the laughter and the will be given to Daffy to start his paranormal business.

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