his colleagues in a fine restaurant. While waiting for the meals to be served, a guest had told a very amusing joke and the patient began to laugh heartily, "Ha, ha, ha, ha..." in decrescendo until he was out of breath. To everyone's surprise, he then fell forward resting his head on the table and remained unresponsive for a few seconds before regaining consciousness. Prior to losing consciousness, he described feeling short of breath and noted that his surroundings were becoming dark. No seizure-like activity or incontinence was witnessed. After the episode he denied nausea, diaphoresis or otherwise feeling sick and proceeded to eat when his entrée was served. The remainder of the evening was without incident.