Recognizing involuntary emotional expression disorder.

Involuntary crying or laughing are symptoms of a condition known as involuntary emotional expression disorder (IEED). This disorder is common among patients with stroke and other neurological disorders, such as multiple sclerosis, amyotrophic lateral sclerosis, and traumatic brain injury. Despite its prevalence, this condition is underrecognized and consequently undertreated in neurological settings. IEED can become disabling for patients who are not accurately diagnosed and treated. Differential diagnosis depends on recognition of the condition as an affective disorder and on its delineation from unipolar depression and other major psychiatric disorders. Clinical evaluation is essential for effective nursing care of this disorder. When the condition is found to be present, effective management must include education, pharmacological treatment, and teaching of self-care strategies. As patient advocates, neuroscience nurses are in a unique position to identify and assess such patients and to effectively guide patients and families in the management of this condition.