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https://www.readbyqxmd.com/read/28125430/pseudobulbar-affect-what-nurses-stroke-survivors-and-caregivers-need-to-know
#1
Melissa A Schneider, Matthew D Schneider
Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. In this syndrome, involuntary, uncontrollable, and inappropriate emotional outbursts unrelated or out of proportion to the situation are common symptoms. This can be very frustrating and scary. Because stroke survivors and their caregivers are overloaded with information during the transition from hospital to home, information about PBA is not usually discussed. In a survey by the National Stroke Association, 53% of stroke survivors reported that they had some of the symptoms of this disorder...
January 25, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28072907/symptomatic-treatments-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#2
REVIEW
Louisa Ng, Fary Khan, Carolyn A Young, Mary Galea
BACKGROUND: Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited. OBJECTIVES: To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND. METHODS: We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND...
January 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28044945/recognizing-and-treating-pseudobulbar-affect
#3
William M Sauvé
Pseudobulbar affect, thought by many to be a relatively newly described condition, is in fact a very old one, described as early as the 19th century. It refers to those who experience inappropriate affect, disconnected from internal state, or mood, generally thought to be the result of an upper motor neuron injury or illness. One possible explanation for this condition's relative obscurity is the dearth of treatment options; clinical medicine is not typically in the habit of identifying conditions that cannot be modified...
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27997281/use-of-compounded-dextromethorphan-quinidine-suspension-for-pseudobulbar-affect-in-hospice-patients
#4
Robert G Wahler, Alfred T Reiman, Joshua V Schrader
BACKGROUND: Pseudobulbar affect (PBA) consists of unprovoked and uncontrollable episodes of laughing and/or crying. In end-of-life situations, PBA symptoms can be especially distressing to family and friends during an already heightened emotional time. Although a commercial product combining dextromethorphan and quinidine (DMQ) is FDA approved for use in PBA, many hospice patients are unable to swallow any solids or semisolids. An alternative formulation for these patients is needed. OBJECTIVE: We present here two cases in which we used a compounded DMQ suspension successfully to treat PBA symptoms in the weeks before the patients' death...
December 20, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27905359/-clinical-and-neuropsychological-features-of-alzheimer-s-disease-in-the-combination-with-cerebrovascular-disease
#5
N A Trusova, O S Levin, A V Arablinsky
AIM: To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). MATERIAL AND METHODS: Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27855728/dextromethorphan-quinidine-responsive-pseudobulbar-affect-pba-psychopharmacological-model-for-wide-ranging-disorders-of-emotional-expression
#6
Stephen M Stahl
The symptoms of emotional dysregulation associated with the syndrome known as pseudobulbar affect (PBA) can be effectively treated by the sigma, glutamate, and serotonergic agent dextromethorphan combined with quinidine. If the same brain circuits affected in PBA are also compromised in related disorders of emotional expression, dextromethorphan-quinidine and other novel sigma-glutamate-serotonin agents could prove to be novel psychopharmacologic treatments for these conditions as well.
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27831974/outcomes-of-palatal-lift-prosthesis-on-dysarthric-speech
#7
Firas S D Alfwaress, Abdel Rahim Bibars, Abedelhadi Hamasha, Emad Al Maaitah
PURPOSE: This study was designed to investigate the effect of palatal lift prosthesis (PLP) on the speech of individuals with different types of dysarthria. PARTICIPANTS: Thirty (19 males and 11 females) native speakers of Jordanian Arabic with dysarthria participated in the study. The age of the participants ranged from 8 to 67 years with an average of 34.1 years. Traumatic brain injury was the most common etiology of dysarthria among 12 participants, stroke among 11, multiple sclerosis among 3, and pseudobulbar palsy among 2; 1 participant had Parkinson disease, and another participant had amyotrophic lateral sclerosis...
January 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27780330/enhancing-approaches-to-the-identification-and-management-of-pseudobulbar-affect
#8
David W Crumpacker
Pseudobulbar affect (PBA) is a socially debilitating condition that primarily affects people with neurologic diseases, such as Alzheimer's disease or multiple sclerosis. This condition is characterized by uncontrolled, exaggerated expressions of laughing or crying-often when the situation does not warrant this behavior. Although the true prevalence of PBA is surprisingly high, this condition remains widely misdiagnosed and underdiagnosed. While its exact etiology is unknown, PBA likely results from disruptions in the brain structures and/or neurotransmitters that regulate emotions...
September 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27737868/bulbar-dysfunction-and-aspiration-pneumonia-due-to-a-brainstem-haemangioblastoma-an-unusual-complication-of-von-hippel-lindau-disease
#9
Christos Panayi, Nagui Antoun, Richard Sandford
A 44-year-old woman with a history of von Hippel-Lindau (VHL) disease, a rare inherited neoplasia syndrome, presented acutely to hospital with a productive cough, symptoms of respiratory tract infection and odynophagia (painful swallowing). A chest X-ray confirmed right-sided pneumonia. Investigation of the persistent odynophagia using barium swallow revealed aspiration of the contrast into the lungs and suggested a neurological cause for her chest infection. Clinical assessment and speech and language therapy confirmed a pseudobulbar palsy...
October 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27723710/-clinical-and-neuropsychological-features-of-alzheimer-s-disease-in-the-combination-with-cerebrovascular-disease
#10
N A Trusova, O S Levin, A V Arablinsky
AIM: To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). MATERIAL AND METHODS: Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27606284/acute-pseudobulbar-palsy-after-bilateral-paramedian-thalamic-infarction-a-case-report
#11
Hye Yeon Lee, Min Jeong Kim, Bo-Ram Kim, Seong-Eun Koh, In-Sik Lee, Jongmin Lee
Bilateral paramedian thalamic infarction is a rare subtype of stroke caused by occlusion of the artery of Percheron, an uncommon variant originating from one of the posterior cerebral arteries. This type of stroke has several major clinical presentations: altered mental status, behavioral amnestic impairment, aphasia or dysarthria, ocular movement disorders, motor deficits, cerebellar signs, and others. Few cases of bilateral paramedian thalamic infarction-related pseudobulbar palsy characterized by dysarthria, dysphagia, and facial and tongue weakness have been reported...
August 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27590297/erratum-to-prism-ii-an-open-label-study-to-assess-effectiveness-of-dextromethorphan-quinidine-for-pseudobulbar-affect-in-patients-with-dementia-stroke-or-traumatic-brain-injury
#12
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
No abstract text is available yet for this article.
2016: BMC Neurology
https://www.readbyqxmd.com/read/27496344/cough-suppressant-and-fluoxetine-in-the-treatment-of-pseudobulbar-affect-a-case-report
#13
Mary I Butler, David Williams, David R Cotter
No abstract text is available yet for this article.
October 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27293347/an-unusual-case-of-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-with-occipital-lobe-involvement
#14
Bhavesh Trikamji, Mariam Thomas, Gasser Hathout, Shrikant Mishra
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant angiopathy caused by a mutation in the notch 3 gene on chromosome 19. Clinically, patients may be asymptomatic or can present with recurrent ischemic episodes and strokes leading to dementia, depression, pseudobulbar palsy, and hemi- or quadraplegia. Additional manifestations that have been described include migraine (mostly with aura), psychiatric disturbances, and epileptic seizures...
April 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27276999/prism-ii-an-open-label-study-to-assess-effectiveness-of-dextromethorphan-quinidine-for-pseudobulbar-affect-in-patients-with-dementia-stroke-or-traumatic-brain-injury
#15
RANDOMIZED CONTROLLED TRIAL
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
BACKGROUND: Phase 3 trials supporting dextromethorphan/quinidine (DM/Q) use as a treatment for pseudobulbar affect (PBA) were conducted in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). The PRISM II study provides additional DM/Q experience with PBA secondary to dementia, stroke, or traumatic brain injury (TBI). METHODS: Participants in this open-label, multicenter, 90-day trial received DM/Q 20/10 mg twice daily. The primary outcome was the Center for Neurologic Study-Lability Scale (CNS-LS), assessing change in PBA episode frequency and severity...
June 9, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27139517/pharmacology-of-dextromethorphan-relevance-to-dextromethorphan-quinidine-nuedexta%C3%A2-clinical-use
#16
REVIEW
Charles P Taylor, Stephen F Traynelis, Joao Siffert, Laura E Pope, Rae R Matsumoto
Dextromethorphan (DM) has been used for more than 50years as an over-the-counter antitussive. Studies have revealed a complex pharmacology of DM with mechanisms beyond blockade of N-methyl-d-aspartate (NMDA) receptors and inhibition of glutamate excitotoxicity, likely contributing to its pharmacological activity and clinical potential. DM is rapidly metabolized to dextrorphan, which has hampered the exploration of DM therapy separate from its metabolites. Coadministration of DM with a low dose of quinidine inhibits DM metabolism, yields greater bioavailability and enables more specific testing of the therapeutic properties of DM apart from its metabolites...
August 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27091117/behavioral-treatment-of-pseudobulbar-affect-a-case-report
#17
Laurence P Perotti, Latiba D Cummings, Janyna Mercado
PURPOSE: To determine if it is possible to successfully treat pseudobulbar affect (PBA) using a behavioral approach. DESIGN AND METHODS: Two experiments were conducted, each a double reversal design with the same single subject in both. The first experiment tested the hypothesis that the rate of PBA could be controlled by manipulation of its consequences. The second experiment tested the hypothesis that use of a self-control procedure would control the rate of PBA...
April 2016: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/27084214/late-onset-spastic-paraplegia-type-10-spg10-family-presenting-with-bulbar-symptoms-and-fasciculations-mimicking-amyotrophic-lateral-sclerosis
#18
Seiji Kaji, Toshitaka Kawarai, Ryosuke Miyamoto, Hiroyuki Nodera, Lucia Pedace, Antonio Orlacchio, Yuishin Izumi, Ryosuke Takahashi, Ryuji Kaji
Pathogenic mutations in the KIF5A-SPG10 gene, encoding the kinesin HC5A, can be associated with autosomal dominant hereditary spastic paraplegia (ADHSP). It accounts for about 10% of the complicated forms of ADHSP. Peripheral neuropathy, distal upper limb amyotrophy, and cognitive decline are the most common additional clinical features. We examined a 66-year-old Japanese woman manifesting gait disturbance and spastic dysarthria for 6years with positive family history. She showed evidence of upper and lower motor neuron involvement and fasciculations, thus mimicking amyotrophic lateral sclerosis (ALS)...
May 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27073382/tongguan-liqiao-acupuncture-therapy-improves-dysphagia-after-brainstem-stroke
#19
Chun-Hong Zhang, Jin-Ling Bian, Zhi-Hong Meng, Li-Na Meng, Xue-Song Ren, Zhi-Lin Wang, Xiao-Yan Guo, Xue-Min Shi
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results...
February 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27015166/therapeutic-approach-of-a-high-functioning-individual-with-traumatic-brain-injury-and-subsequent-emotional-volatility-with-features-of-pathological-laughter-and-crying-with-dextromethorphan-quinidine
#20
Dynela Garcia-Baran, Thomas M Johnson, Joyce Wagner, Joann Shen, Michelle Geers
Pathological laughing and crying, or pseudobulbar affect (PBA), has been described in patients with neurological disorders such as multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer's disease, stroke, and traumatic brain injury (TBI) since the 19th century (Schiffer 2005). The syndrome is characterized by inappropriate episodes of laughing or crying after minor stimuli. It was first coined a disinhibition of cortical control by Kinnier Wilson in 1924. It was observed in brain disease and seen with mild TBI...
March 2016: Medicine (Baltimore)
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