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[Pseudobulbar affect in stroke patients in Argentina]
Matías Alet1, Constanza Segamarchi, Santiago Claverie
1Sección de Enfermedades Cerebrovasculares, Servicio de Neurología. Hospital J.M. Ramos Mejía, Ciudad de Buenos Aires, Argentina.
Background:
Pseudobulbar affect is defined by involuntary or exaggerated episodes of laughter or crying, subsequent to a specific disease. After-stroke pseudobulbar affect is reported in 11%-34% of patients. In our population is underdiagnosed. Our objective was to determine its frequency in a group of stroke patients.
Patients And Methods:
Prospective observational study from June/2017 to June/2018. Two populations were evaluated: chronic stroke (Group A) and acute stroke (Group B). Patients with severe psychiatric illness, cognitive impairment and/or aphasia were excluded. PLACS ("pathological laughing and crying scale") and CNS-LS ("lability scale for pseudobulbar affect") scales were performed. Pseudobulbar affect was defined with diagnostic criteria plus both positive scales.
Results:
Fifty patients were evaluated. Sixty-eight percent were men. Mean age: 65±12 years. Group A: 19 cases and group B: 31 cases. Positive PLACS: 21% group A and 29% group B. Positive CNS-LS: 58% group A and 26% group B. Both positive scales in 8 patients (2 in group A and 6 in group B). Three of them had associated depression.
Conclusions:
Pseudobulbar affect should be screened after stroke. Post-stroke depression is frequent and differential diagnose with emotional lability attributable to pseudobulbar affect must be ruled out. The administration of a single scale would not be sufficient for diagnostic guidance.
