Understanding excessive crying in neurologic disorders: nature, pathophysiology, assessment, consequences, and treatment.
OBJECTIVE
The goal of this review is to provide an overview of the literature on excessive crying (EC) in neurologic disorders.


BACKGROUND
EC implies that a person has difficulty keeping his emotional behavior under control and it occurs in a number of neurologic disorders.


METHODS
Intensive literature searches were carried out to address the following 4 questions: (1) What is EC and what effects does it have? (2) In which disorders is EC common? (3) How can EC be diagnosed? and finally, (4) Can EC be treated?


RESULTS
EC is common in a variety of neurologic disorders including amyotrophic lateral sclerosis, stroke, and multiple sclerosis whereas brain regions implicated may be both focal and/or diffuse. Both in a qualitative and quantitative way, EC does not clearly differ from crying in normal adults. There is a remarkable similarity between the precipitating factors in normal crying and EC. Three questionnaires for the diagnosis of EC have been developed. Treatment with low doses of antidepressants yields promising results.


CONCLUSIONS
We recommend choosing one term for the phenomenon of EC that does justice to the fact that the threshold for such crying is exceptionally low. This may reduce confusion in the literature and among health professionals. The neurologic origin of EC has yet to be fully mapped out. Antidepressants are the treatment of choice for EC whereas early treatment should be the goal for both patients and their carers.
Department of Psychology and Health, University of Tilburg, Tilburg, The Netherlands. R.E.Mark@uvt.nl
Ruth Elaine
RE
Nieuwenhuis-Mark
Anneke
A
van Hoek
Ad
A
Vingerhoets
D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000503:physiopathology; D000928:Antidepressive Agents / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology*; D003448:Crying / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology
D000928:Antidepressive Agents