The lesion distribution pattern of poststroke pathological laughing and crying:an MRI study / 中华行为医学与脑科学杂志

ABSTRACT

Objective To explore the lesion distribution pattern of poststroke pathological laughing or crying (PSPLC) by using MRI,and to discuss its pathogenesis. Methods All 24 cases selected from stroke patients who were treated in the department of neurology from May 2012 to December 2015 and had complete follow?up information after their discharge through 6 months were screened for pathological laughing and crying( PLC) . MRI characteristics of cases were analyzed retrospectively to identify lesion distribution. 28 cases with acute isolated pontine infarction who did not demonstrate PLC were enrolled as a comparison group. Lesion pattern difference between 14 cases of the pontine infarction with PLC and 28 cases of acute i?solated pontine infarction without PLC was compared. Results In these 24 cases,the highest occurrence rate of PLC was 41.67% in the second month. 15 cases had forced crying (62.5%),3 cases had forced laughing (12.5%),6 cases had pathological laughing or crying (25%). MRI studies showed lesion location in the left side were 3 cases,in the right side were 1 case,in the bilateral brain were 20 cases,in the basal ganglia were 9 cases,in the thalamus were 8 cases,in the corona radiata were 6 cases,in the semioval center were 5 cases, in the cerebral cortex were 4 cases,in the cerebellum were 4 cases and in the brain stem were 14 cases. In the cases of PLC with brain stem lesion,only 1 case was isolated pontine infarction,the other patients all combined with lesions of other parts. Compared with the pontine infarction with PLC,the isolated pontine in?farction without PLC was more likely to suffer with unilateral brain lesions(71%vs 50%),but there was no significant difference (χ2=0.844, P=0.358) . Conclusion PSFLC is not a rare complication after stroke, which is associated with multiple site of brain involvement especially pontine infarction.