Emotionalism is an increase in the frequency of crying (shedding tears, sobbing) or laughing episodes in comparison to the patient’s condition before the disease.
Emotionalism might be one main symptom of stroke or other neurological disorders (vascular, traumatic, degenerative, neoplastic or inflammatory origin). Emotionalism is also frequent with psychotic and primary mood disorders. However, emotionalism or emotional susceptibility could be also a persistent personality trait (in this case there is no change from the baseline condition)
In 1924, S.A.K. Wilson formulated a general theory on the neural correlates of emotionalism in neurological disorders. This theory postulates the existence of two cortical systems connected by the corticospinal tracts to a hypothetical “crying-laughing” facial-respiratory center in the brainstem, responsible for the motor commands of crying and laughter. The first system, located in the frontal lobes and in the motor cortex, exercises a volitional control, whereas the second, presumably connected to the limbic system, processes the emotional valence of the external stimuli and allows laughing and crying emerge involuntarily. According to this theory, the emergence of abnormal laughter and crying is due to the imbalance between the two systems and, for this reason, may manifest even after unilateral lesions. The Wilson’s theory of emotionalism is still the most influential.
However, it is still unknown whether neural systems of crying and laughter are the same, to what extent they overlap and whether they are subjected to the control of similar cognitive or motor processes. Crying and laughter out of control are cause of embarrass and suffering, which differentiates the emotionalism due to neurological diseases from ‘normal crying and laughing’.
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