Pseudobulbar Affect or Depression - A Clinician’s Dilemma
Abstract
Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of traumatic brain injury, stroke, brain tumours and extra pyramidal & cerebellar disorders. We present a case of 50 years old male, presenting with involuntary crying spells but no significant findings on neuroimaging or other investigations, leading to initial misdiagnosis of depression. Though there are characteristic features that can be recognized clinically for accurate identification of PBA, there needs to be a high level of suspicion and thorough clinical evaluation on the part of clinician for accurate diagnosis of PBA and early intervention.
How to cite this article:
Bansal P, Aggarwal S, Jiloha RC. Pseudobulbar Affect or Depression - A Clinician’s Dilemma. J Adv Res Psychol Psychother 2019; 2(3&4): 35-37.
DOI: https://doi.org/10.24321/2581.5822.201914
References
Parvizi J, Arciniegas DB, Bernardini GL, Hoffmann MW, Mohr JP, Rapoport MJ et al. Diagnosis and management
of pathological laughter and crying. Mayo Clin Proc 2006; 81(11): 1482-1486. Available from: https://
www.mayoclinicproceedings.org/article/S0025-6196(11)61255-X/fulltext [PubMed/ Google Scholar].
Parvizi J, Coburn KL, Shillcutt SD, Coffey CE, Lauterbach EC, Mendez MF. Neuroanatomy of pathological
laughing and crying: a report of the American Neuropsychiatric Association Committee on Research.
J Neuropsychiatry Clin Neurosci 2009; 21(1): 75-87. Available from: https://neuro.psychiatryonline.org/
doi/full/10.1176/jnp.2009.21.1.75?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_
pub++0pubmed& [PubMed/ Google Scholar].
Moore SR, Gresham LS, Bromberg MB, Kasarkis EJ, Smith RA. A self report measure of affective lability.
J Neurol Neurosurg Psychiatry 1997; 63(1): 89-93. Available from: https://jnnp.bmj.com/content/63/1/89.long [PubMed/ Google Scholar].
Ahmed A, Simmons Z. Pseudobulbar affect: prevalence and management. Department of neurology, Penn
state Hershey medical college, USA. 2013; 9: 483-448. Available from: https://pennstate.pure.elsevier.com/
en/publications/pseudobulbar-affect-prevalence-andmanagement.
Poeck K. Pathophysiology of emotional disorders associated with brain damage. In: Vinken PJ, Bruyn
GW, editor. Handbook of Clinical Neurology. 1969; 3: 343-367. Available from: https://philpapers.org/rec/
POEPOE.
Cummings JL, Arciniegas DB, Brooks BR, Herndon RM, Lauterbach EC, Pioro EP et al. Defining and diagnosing
involuntary emotional expression disorder. CNS Spectr 2006; 11(6): 1-7. [PubMed/ Google Scholar].
Segamarchi MC, Alet M, Claverie S, Lepera S, Gonzalez LA, Rey R. Pseudobulbar affect in patients with stroke.
Neurology 2019; 92(15S): P3.3-028.