Pathological laughter, pseudobulbar affect or a myriad of its other synonyms, is a condition common secondary to neurological injury, presenting with uncontrolled laughing or crying, appearing to be mood-incongruent and significantly debilitating. The objective of this case report is to highlight a rare case of pathological laughter associated with Cerebral Lupus. Methods: We report a case of a 27-year-old lady presenting with signs and symptoms of stroke with dysarthria progressing to aphasia and then pathological laughter, with an underlying poorly controlled Systemic Lupus Erythematosus, manifesting as Cerebral Lupus. Results: An improvement in affect congruency followed by decreased frequency of outbreaks among bouts of pathological laughter. Conclusion: The combination of Escitalopram and Topiramate is effective in the symptomatic treatment of Pathological Laughter. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.