The clinical study of citalopram on affective disorder after cerebral infarction / 中华行为医学与脑科学杂志

Objective To investigate efficacy of citalopram on pathological crying after cerebral infarction.Methods 106 patients with pathological crying after cerebral infarction were randomly divided into two groups,treatment group(54 cases) and control group(52 cases).Control group received conventional treatment of cerebrovascular disease.Treatment group taken citalopraml0-20mg orally one time per day for three months based on conventional treatment.The total response rate,effectual time,and Hasegawa Dementia Scale (HDS) scores were compared between two groups after treatment.Results There were significant differences in total response rates (94.4％ and 38.5％,respectively),effectual time(1.98 ± 1.24 and 78 ± 17.95,respectively) and HDS(8.43 ±2.21 and 6.24 ±2.02,respectively) between treatment group and control group (P ＜ 0.01).Conclusion The study suggests that it is effective to treat pathological crying with citalopram and its effect is quick.Citalopram can not only control patient’s pathological crying,but also improve cognitive function.

A Case of Pathologic Crying, Delusion and Memory Impairment Due to Hemorrhage in the Right Basal Ganglia / 대한뇌졸중학회지

Gradual decline in cognitive function and behavioral changes are characteristic in degenerative dementia. Although acute to subacute subcortical lesion can affect behavior and cognition, few reports have described both cognitive and behavioral deficits in patients with right basal ganglia lesion. An 82-year-old man presented with memory impairment, pathological crying, delusion and other psychological symptoms that developed insidiously over the previous 2 months. Initially, the patient had been diagnosed with degenerative dementia, but brain MRI showed the hematoma in the right basal ganglia. Our case shows that cognitive dysfunction, behavioral and psychological symptoms including pathological laughing and delusion can be developed concurrently by the lesion of the right basal ganglia. Our case suggests that cerebrovascular disease should be considered in elderly patients presenting with subacute cognitive and behavioral deterioration, even when there were no other neurological signs.

Extra Pontine Myelinolysis without Striatal involvement Presenting as Pathological Crying, Reversible Parkinsonism and Dystonia.

A case of Central Pontine Myelinolysis and Extrapontine Myelinolysis presented with dystonia, Parkinsonism, and pathological crying that developed few days after gradual correction of hyponatremia. EEG slowing was evident before onset of symptoms, and disappeared with clinical improvement. Thalamic lesions alone produced these features. It dramatically responded to the Trihexyphenidyl therapy. Thus, basal ganglia involvement is not mandatory to produce this clinical picture; early onset of symptoms, resolution of EEG slowing and prompt response to anticholinergics may indicate better prognosis.