China
Africa
Explore chapters and articles related to this topic
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Can experience behavior and language symptoms associated with the other FTD syndromes. Motor symptoms arise from motor neuron dysfunction similar to those seen in ALS and may include: Muscle weakness affecting the arms, legs, face, tongue, or neck.Clumsiness, tripping, or falling due to weak or stiff legs.Shortness of breath.Muscle atrophy, fasciculations, muscle cramps.Dysphagia.Dysarthria.Spasticity.Hyperreflexia.Pseudobulbar affect (uncontrollable outbursts of laughing or crying).
Disruptions in physical substrates of vision following traumatic brain injury
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
The cerebellum is involved with spatial organization and memory. It is also involved in refining motor control and probably motor learning. Although it only makes up about 10% of the total brain volume, it is densely packed with neurons (mostly tiny granule cells). The vestibulocerebellum participates in balance and spatial orientation. It mainly receives vestibular input along with visual and other sensory input. The spinocerebellum functions to fine-tune body and limb movements. It receives proprioceptive input as well as input from visual and auditory systems and the trigeminal nerve. It sends fibers to the deep cerebellar nuclei that project to the cerebral cortex and also to the brain stem to modulate descending motor systems. The cerebrocerebellum receives input exclusively from the cerebral cortex, especially the parietal lobe, via the pontine nuclei, and sends outputs to the ventrolateral thalamus. The cerebrocerebellum is involved in planning movement, evaluating sensory information for movement, and some cognitive functions, including emotional control. A defect in this system results in pseudobulbar affect.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Pseudobulbar affect (also described as emotional lability or emotional incontinence) describes sudden uncontrollable outbursts of laughter or tearfulness and affects 20%-50% of patients with ALS and has an increased prevalence in MS as well as stroke patients. The combination drug dextromethorphan-quinidine (20mg/10mg) has been shown to reduce the frequency and severity of laughing and to improve quality of
Combinations of dextromethorphan for the treatment of mood disorders - a review of the evidence
Published in Expert Review of Neurotherapeutics, 2023
Zamfira Parincu, Dan V. Iosifescu
A significant number of the early clinical trials with dextromethorphan show minimal CNS effects, perhaps due to dextromethorphan’s rapid first-pass metabolism that could have limited brain exposure. To increase bioavailability in the CNS, dextromethorphan was initially combined with quinidine, an inhibitor of the cytochrome P450 2D6 (CYP2D6), the primary liver enzyme involved in dextromethorphan’s metabolism [21]. The dextromethorphan-quinidine combination received FDA approval in 2010 for the treatment of pseudobulbar affect (PBA), a neurologic condition characterized by sudden uncontrollable and inappropriate crying or laughing [25]. Of note, quinidine has limited penetration into the brain, and its role in the dextromethorphan-quinidine combination is strictly to delay dextromethorphan’s metabolism.
Eye movement desensitization and reprocessing for post-stroke post-traumatic stress disorder: Case report using the three-phase approach
Published in Brain Injury, 2022
There are a number of evidence-based treatments for PTSD. Several of these are cognitive and/or behaviorally based, such as cognitive processing therapy [CPT; Resick, Monson, & Chard, 13], prolonged exposure [PE; 14], and trauma-focused cognitive-behavioral therapy [TF-CBT; 15]. However, these approaches may not work for all patient populations, including those with co-occurring neurological disorders. For example, PE and CPT have been found to have substantial drop-out rates (16), which may be due to the aversive nature of the exposure. Managing dysregulation that can arise from exposure to traumatic material may be further challenged in persons with neurological disorders who are experiencing neurological dysregulation, such as pseudobulbar affect (17). Additionally, CBT-oriented approaches such as CPT and TF-CBT may be limited by their reliance on verbal expression of trauma narratives, which could be compromised in certain patients such as those with post-stroke aphasia or other cognitive impairments (18). Finally, the recent APA guidelines for the treatment of PTSD (19) have been criticized as being too cognitive/behaviorally focused (20) and may lack ecological validity for many persons with trauma (21), including those with more complex trauma presentations such as child abuse histories.
Current perspectives on co-morbid depression and multiple sclerosis
Published in Expert Review of Neurotherapeutics, 2020
In most cases of pseudobulbar affect, its expressions are not entirely black and white (e.g. laughing while sad, crying while happy, although this can occur). The syndrome is usually characterized by emotional symptoms that are out of proportion to their triggers [53]. There is consequently a superficial resemblance to depression, where negative cognitive distortions may lead to what appears also to be an exaggerated emotional response – for example, a minor loss may seem devastating or the future may look hopeless or even catastrophic due to a negativistic cognitive stance. The key difference, again, is in in the discordance between subjectively experienced emotions and their outward affective expressions. In pseudobulbar affect, patient’s expressions of affect are often intense or ‘over the top’ whereas those affected will generally subjectively report only mildly dysphoric emotions.