Pathological laughing and crying

Introduction Severe brain organic damage, such as cerebral arteriosclerosis, brain tumors, encephalitis, multiple sclerosis, etc., can sometimes occur pathological laughter. If there is a person with a brain disorder, there is no reason to laugh, often a signal that the disease is heavier, and should be treated in time. Involuntary crying and laughter, when one or both sides of the bridge bottom blood vessels are damaged, some patients may also be accompanied by pathological crying, and pathological laughter, which is characterized by a sudden onset of involuntary crying. Shouting or laughing for 15 to 30 minutes, this emotional out of control can be used as a sign of a brain stem stroke, or in the next few days.

Cause

Severe brain organic damage, such as cerebral arteriosclerosis, brain tumors, encephalitis, multiple sclerosis.

an examination

Related inspection

Brain CT examination of brain ultrasound

Involuntary crying and laughter, when one or both sides of the bridge bottom blood vessels are damaged, some patients may also be accompanied by pathological crying, and pathological laughter, which is characterized by a sudden onset of involuntary crying. Shouting or laughing for 15 to 30 minutes, this emotional out of control can be used as a sign of a brain stem stroke, or in the next few days. The anatomical connection between the bottom of the bridge and the emotional out of control is still unclear, but from the majority of patients with pathological crying or laughing, the pseudobulbar paralysis with bilateral frontal or apical fibrous lesions, some researchers It is speculated that the real cause is the release of the cortical inhibition center, that is, the crying and laughing center located at the bridge cover, which inhibits the interruption of the conduction path of the skin extension bundle when the bottom of the bridge is damaged.

Patients with bilateral forebrain disease usually develop pathological laughter and tearing syndrome.

After multiple sclerosis, especially after entering the chronic phase, about 10% of patients have pathological laughter.

The prion disease (infectious spongiform encephalopathy) is a spongiform pathological change in brain tissue. There may be emotional instability, accompanied by pathological paroxysmal laughter, dementia may occur in the extreme stage.

Differential diagnosis

Smirking: It is a special sneer. More common in patients with brain hypoplasia and senile dementia. This kind of laugh is not self-made, without any stimulation, can appear under any circumstances, no emotional color, so the patient is often happy, but due to the influence of intelligent obstacles, facial expressions give people a feeling of stupidity, no infection force.

Idiot: I am seen in patients with schizophrenia. Because of the abnormal function of the brain, when you laugh, you can sneer alone or laugh. For youthful schizophrenia, smirking is an important feature. But this kind of emotional instability, sometimes suddenly converging smiles, serious expressions; sometimes it is laughable and embarrassing.

Weird smile: more common in patients with facial paralysis and paralysis. As the innervation is weakened or lost, the muscles on the side of the affected side are loose, the nasolabial folds become shallow, and the corners of the mouth are pulled to the healthy side when laughing, the mouth is skewed, and the expression is weird.

Smirk: more common in patients with occult depression. Originally, such patients are depressed in their hearts, but often smirk at people, and experienced doctors often find it.

Strong laugh: Strong laughter is a kind of laugh that can't be restrained. It is more common in patients with brain organic diseases such as senile diffuse cerebral arteriosclerosis. Cranial trauma and brain tumors can also be caused.

Paroxysmal laughter: manifested as paroxysmal inability to laugh spontaneously, many people attack several times to dozens of times a day, from a few days to several weeks, each episode lasts tens of seconds to several minutes, is a laugh Characteristics of sexual epilepsy. In addition to laughter, the disease is often accompanied by ADHD, EEG changes (indefinite duration) and varying degrees of disturbance of consciousness.

Laughter: more common in after drinking or rickets.

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