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[Pathological crying and unilateral pontine infarction]
R de Oliveira-Souza1, W M de Figueiredo, P A Andreiuolo
1Serviço de Clínica Médica C, Hospital Universitário Gaffrée, e Guinle, UNI-RIO (HUGG-UNI-RIO), Rio de Janeiro, Brasil.
Arquivos De Neuro-Psiquiatria
|September 1, 1995
Summary
Pathologic crying, a symptom of brainstem lesions, can be treated with imipramine. This condition is a limbic-motor disconnection, not pseudobulbar palsy, due to distinct brainstem systems.
Area of Science:
- Neurology
- Neuroscience
- Neuroanatomy
Background:
- Pathologic crying and laughing are involuntary emotional expressions.
- These symptoms are often associated with neurological disorders.
- Understanding the underlying neuroanatomy is crucial for accurate diagnosis.
Observation:
- A 64-year-old man experienced pathologic crying and right hemiplegia.
- The symptoms stemmed from a unilateral pontine infarct, likely due to basilar artery branch disease.
- Magnetic Resonance Imaging (MRI) and short-latency evoked potentials confirmed a localized lesion.
Findings:
- Low-dose imipramine effectively resolved the patient's weeping spells within days.
- Pathologic laughing and crying are proposed to be a limbic-motor disconnection syndrome.
- This syndrome involves the release of the faciovocal motor system from forebrain emotional input.
Implications:
- The findings suggest distinct functional and anatomic systems for pathologic laughing and crying within the brainstem.
- Classifying these symptoms under pseudobulbar palsy is considered inaccurate and misleading.
- This research highlights the importance of precise neuroanatomical localization for understanding and treating emotional dysregulation.