Alet Matías, Segamarchi Constanza, Claverie Santiago, Gonzálezy Leonardo, Lepera Sandra, Rey Raúl
Sección de Enfermedades Cerebrovasculares, Servicio de Neurología. Hospital J.M. Ramos Mejía, Ciudad de Buenos Aires, Argentina. E-mail:
Vertex. 2020 Apr;XXX(148):1-5. doi: 10.53680/vertex.v30i148.123.
Pseudobulbar affect is defined by involuntary or exaggerated episodes of laughter or crying, subsequent to a specific disease. After-stroke pseudobulbar affect is reported in 11%-34% of patients. In our population is underdiagnosed. Our objective was to determine its frequency in a group of stroke patients.
Prospective observational study from June/2017 to June/2018. Two populations were evaluated: chronic stroke (Group A) and acute stroke (Group B). Patients with severe psychiatric illness, cognitive impairment and/or aphasia were excluded. PLACS ("pathological laughing and crying scale") and CNS-LS ("lability scale for pseudobulbar affect") scales were performed. Pseudobulbar affect was defined with diagnostic criteria plus both positive scales.
Fifty patients were evaluated. Sixty-eight percent were men. Mean age: 65±12 years. Group A: 19 cases and group B: 31 cases. Positive PLACS: 21% group A and 29% group B. Positive CNS-LS: 58% group A and 26% group B. Both positive scales in 8 patients (2 in group A and 6 in group B). Three of them had associated depression.
Pseudobulbar affect should be screened after stroke. Post-stroke depression is frequent and differential diagnose with emotional lability attributable to pseudobulbar affect must be ruled out. The administration of a single scale would not be sufficient for diagnostic guidance.
假性球麻痹情感障碍的定义为特定疾病后出现的不由自主或夸张的哭笑发作。中风后假性球麻痹情感障碍在11%-34%的患者中被报道。在我们的人群中，该疾病诊断不足。我们的目的是确定一组中风患者中其发生率。
2017年6月至2018年6月的前瞻性观察研究。评估了两个人群：慢性中风患者（A组）和急性中风患者（B组）。排除患有严重精神疾病、认知障碍和/或失语症的患者。进行了PLACS（“病理性哭笑量表”）和CNS-LS（“假性球麻痹情感障碍易激惹量表”）量表评估。假性球麻痹情感障碍根据诊断标准加两个阳性量表来定义。
评估了50例患者。68%为男性。平均年龄：65±12岁。A组：19例，B组：31例。PLACS阳性：A组21%，B组29%。CNS-LS阳性：A组58%，B组26%。8例患者两个量表均为阳性（A组2例，B组6例）。其中3例伴有抑郁症。
中风后应筛查假性球麻痹情感障碍。中风后抑郁症很常见，必须排除与假性球麻痹情感障碍所致情绪不稳定的鉴别诊断。使用单一量表不足以进行诊断指导。
