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Posted by CCF Neurology MD on September 18, 1997 at 20:18:50:
In Reply to: emotive incontinence posted by sharon brown on September 12, 1997 at 14:42:30:
: My doctor tells me that my excessive and inappropriate crying is just part of my m.s., that it is emotive incontinence.
My understanding is that this symptom usually is the showing of inappropriate emotions or inappropriate amounts of emotion at various times.
Well, I'm crying at just about anything, yet am not depressed.
It gets very frustrating to discuss the weather and get teary eyed.
What you describe is called emotional lability, emotional incontinence, or pathological crying. It is indeed common in MS, and is also observed with other conditions such as with multiple strokes, ALS (Lou Gehrigs's disease), and some other neurodegenerative conditions. The patient does not experience significant emotion, but may have uncontrolled crying in response to trivial stimuli. Some patients may even have uncontrolled laughter, or may have both. I can understand how embarrassing it must be for you socially. The exact cause of this phenomenon is not clearly known, but may be from some chemical dysregulation in the brainstem resulting from loss of connections and control from the cerebral cortex due to disease. This results in hyperactive or inappropriately active emotional motor reflexes. Studies indicate that drugs called SSRIs (Fluoxetine-Prozac, or paroxetine-Paxil, for instance), and tricyclics (nortriptyline-Pamelor, for instance), may be quite effective in the symptomatic treatment of this problem.
I hope this answers some of your questions. In case you live near the Cleveland area and want a second opinion regarding this problem, or any other MS-related problem, any of the neurologists at the Mellen Center (Dr. Rudick, Dr. Cohen, or Dr. Kinkel) would be glad to see you. The Mellen Center is one of the largest institutions in the US dedicated to MS research and to the multidisciplinary care of MS patients. It is affiliated to the Cleveland Clinic. To make an appointment you would want to call (216)444-8600, or (800)223-2273.
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