BACKGROUND: Pathologic crying, devoid of any emotional counterpart, is known to occur as a consequence of various brain stem, cortical hemispheric and @entity76 or, quite exceptionally, of "dacrystic" @entity302 . The case reported here suggests that @entity9479 may also cause crying spells, under the special circumstances described below. CASE PRESENTATION: After a mild left thalamic @entity64 a caucasian 77  years old @entity1 presented with crying spells with no emotional counterpart, triggered by thumb-index rubbing of his right hand. Only a modest sensation loss on right infra-orbital and nose-labial areas and the first three right fingers could be detected at clinical examination. The circumstances and processes leading to the crying spells were investigated, together with their neural substrate. Brain computerized tomography (CT), magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) were conducted. Neurophysiologic studies included Video-Electroencephalography, Electromyography, motor and sensory Evoked potentials. Active thumb-index rubbing, passive fingertips stimulation and interaction of sensory-motor stimulation with cognitive/speech activities were tested under different paradigms. A treatment with @entity4481 (75  mg twice a day) was attempted. CT and MRI showed a small @entity1188 in the left ventral postero-lateral thalamus, while fMRI led to the expected findings, i.e. a bilateral activation of the hand motor representation during the crying-triggering right-hand finger rubbing activity. Sensory potentials evoked from stimulation of the right upper limb were the only abnormal neurophysiologic test. Crying spells could be invariably evoked by both real and imagined active finger rubbing, in either the left of right hemi-space. Rubbing by an examiner was ineffective. Immersion in water (18    C) but not oiling of the fingertips prevented the symptom. Administration and discontinuation of @entity4481 75  mg daily could be associated with suppression and reappearance of the symptom, respectively. CONCLUSIONS: In this @entity1 loss of sensation seemed to generate crying spells rather than the more common @entity1931 . As a matter of speculation, both symptoms might represent responses to a sensory loss, but in this case the pathway might have been selectively affected providing inhibition from the lateral to the medial segment of the VPLT, which is linked to the anterior cingulate (limbic) cortex engaged in emotional behaviour.

Crying spells triggered by thumb-index rubbing after thalamic XXXX : a case report.

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity1931 :: ('MESH:D006930', 'Disease') :: ['allodynia'] @entity9479 :: ('MESH:D013786', 'Disease') :: ['thalamic lesions'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['ischemic infarct'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy'] @entity76 :: ('MESH:D002526', 'Disease') :: ['cerebellar lesions'] @entity4481 :: ('MESH:C080245', 'Chemical') :: ['pregabalin']
@entity64 :: (MESH:D020521,Disease) :: ['stroke']
