Kekere Victor, Qureshi Danish, Thanju Amod, Fouron Patrice, Olupona Tolulope
Psychiatry, Interfaith Medical Center, Brooklyn, USA.
Cureus. 2022 Jun 23;14(6):e26235. doi: 10.7759/cureus.26235. eCollection 2022 Jun.
Pseudobulbar affect (PBA) is a neurological condition that is associated with short periods of involuntary, sudden, and inappropriate emotions such as crying or laughing, which are mood incongruent. An accurate estimate of the prevalence of PBA is hard to obtain due to varying diagnostic criteria and variable patient populations. The cause of PBA is not known, but current evidence suggests dual etiology. A neural circuit dysfunction and an abnormality of neurotransmitters that regulate motor expression of emotions. PBA can easily be mistaken for a depressive disorder due to the overlap of symptoms. Moreover, patients with PBA may have a major depressive disorder (MDD) or other depressive disorders. Therefore, it is essential to recognize and treat PBA as well as possible psychiatric comorbidities. We present a case report of a 59-year-old man with no past psychiatric history who presents with paroxysms of episodes of crying for the past one year. He endorsed feelings of hopelessness and poor concentration. MRI of the brain revealed bilateral basal ganglia and a thalamic infarct. The patient was treated with citalopram. This case describes a unique presentation of pseudobulbar affect mimicking depression.
假性延髓情绪（PBA）是一种神经系统疾病，与短时间内不自主、突然且不适当的情绪有关，如哭笑，这些情绪与心境不协调。由于诊断标准不同和患者群体各异，很难准确估计PBA的患病率。PBA的病因尚不清楚，但目前的证据表明是双重病因。一种是神经回路功能障碍，另一种是调节情绪运动表达的神经递质异常。由于症状重叠，PBA很容易被误诊为抑郁症。此外，PBA患者可能患有重度抑郁症（MDD）或其他抑郁症。因此，尽可能识别和治疗PBA以及可能存在的精神共病至关重要。我们报告一例59岁男性病例，该患者既往无精神病史，在过去一年中出现阵发性哭泣发作。他认可绝望感和注意力不集中。脑部MRI显示双侧基底节和丘脑梗死。该患者接受了西酞普兰治疗。本病例描述了一例假性延髓情绪模仿抑郁症的独特表现。
