A Review: Understanding Involuntary Emotional Expression Disorder

Defining and diagnosing involuntary emotional expression disorder^{Cummings JL, Arciniegas DB, Brooks BR, et al}

Two standard rating scales are available to evaluate patients with IEED.  The Center for Neurologic Study-Lability Scale (CNS-LS) is a short (seven item), easy to administer scale, that provides a quantitative measure of perceived frequency of IEED episodes, incorporating subscales measuring labile laughter and labile tearfulness^{Smith RA, Berg JE, Pope LE, Callahan JD, Wynn D, Thirsted RA; Moore SR, Gresham LS, Bromberg MB, et al}. It shows high consistency and reliability, and successfully predicts neurologists’ diagnoses of IEED. A CNS-LS score of 13 or higher is suggestive of IEED.

The Pathological Laughing and Crying Scale (PLACS) is an interviewer-rated scale comprising eighteen questions ^{Tateno A, Jorge RE, Robinson RG; Robinson RG, Parikh RM, Lipsey JR, Starkstein SE, Price TR}. It quantifies aspects of laughter and crying, including the relation of the episodes to external events, duration, degree of voluntary control, inappropriateness in relation to emotions, and the degree of resulting distress. This scale can also be used to diagnose IEED. A PLACS score of 13 or higher is suggestive of IEED.