Duloxetine for pathological laughing and crying

Abstract

Pathological laughing and crying (PLC) is a condition characterized by frequent, sudden outbursts of uncontrollable crying and/or laughing that are disproportionate or incongruent to underlying feelings or external triggers (Wortzel et al. 2008). Alternative terms often used to describe this syndrome are pseudobulbar affect, emotional incontinence, emotional or affective lability, organic or pathological emotionalism and involuntary emotional expression disorder. The condition is associated with various neurological disorders, such as stroke, multiple sclerosis, Parkinson's disease, traumatic brain injury, dementia and amyotrophic lateral sclerosis (ALS). PLC can be socially and occupationally disabling and is a source of distress for affected patients and their families. However, it is largely under-recognized or misdiagnosed in clinical settings. An important first step in the recognition and accurate measurement of PLC has been accomplished with the introduction of specific rating scales, such as the interviewer administered Pathological Laughter and Crying Scale validated for use with stroke victims (Robinson et al. 1993) and the self-report Center for Neurologic Study – Lability Scale (CNS-LS) validated for use with ALS and multiple sclerosis patients (Moore et al. …