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Pseudobulbar Affect Presenting as Hypomania
Journal article   Open access   Peer reviewed

Pseudobulbar Affect Presenting as Hypomania

Eduardo D. Espiridion, Cassandra Mitchell and Shreeja Kadakia
Curēus (Palo Alto, CA), v 12(3), pe7308
18 Mar 2020
PMID: 32313749
url
https://doi.org/10.7759/cureus.7308View
Published, Version of Record (VoR)CC BY V4.0 Open

Abstract

General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
Pseudobulbar affect (PBA) is a behavioral syndrome associated with various neurological conditions that typically manifests as uncontrollable laughing or crying. PBA can significantly impact the quality of life of patients affected as these spells can be inappropriate to the social setting or incompatible with the patient's emotional state. The underlying mechanism of PBA appears to be associated with disinhibition in neuronal pathways involving dopamine, serotonin, and glutamate, but the exact mechanism remains unclear. One hypothesis for the pathology of PBA is that it is the result of disruption of the corticopontine-cerebellar circuits, impairing cerebellar modulation of affect, and leading to uncontrolled emotional lability. Stroke, and other neurological disorders, interrupt these neuronal circuits causing disinhibition of the voluntary control of emotional expression. It is extremely important to recognize and appropriately diagnose the condition. We present a case report of an 85-year-old female patient who presented with a thalamic stroke, and she subsequently developed hypomania with symptoms of decreased need for sleep, mood lability, pressured speech, and religious preoccupation. This case discusses a unique presentation of PBA with hypomania.

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Collaboration types
Domestic collaboration
Web of Science research areas
Medicine, General & Internal
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