Patients with stroke often have sequelae such as motor dysfunction, ataxia, visual field defect, etc. However, there still are disturbances that are not apparent and frequently unnoticed by physicians. They include cognitive dysfunction, mood and emotional disturbances, and pain or paresthesia. In this chapter, post-stroke emotional disturbances and pain are described. Post-stroke mood and emotional disturbances are frequent and diverse in their manifestations and can be categorized as post-stroke depression, post-stroke emotional incontinence, post-stroke anger proneness, and post-stroke fatigue. These symptoms are distressing for both the patients and their caregivers and negatively influence the patient’s quality of life. Post-stroke pain includes nociceptive pain, central pain, and headache and is equally distressing for patients. Fortunately, these mood/emotional disturbances and pain syndromes can be treated or prevented by various methods, including pharmacological therapy. To administer the appropriate therapy, we have to understand the phenomenology and the similarities and differences in the pathophysiological mechanisms associated with these phenomena.
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Hackett ML, Anderson CS, House A, et al. Interventions for treating depression after stroke. Cochrane Database Syst Rev. 2008;4:CD003437.Google Scholar
Kim JS, Choi-Kwon S. Disturbances in the voluntary control of emotional expression after stroke. In: Ferro JM, editor. Neuropsychiatric symptoms of cerebrovascular diseases. Heidelberg: Springer; 2013. p. 131–60.CrossRefGoogle Scholar
Kim JS, Choi-Kwon S. Poststroke depression and emotional incontinence: correlation with lesion location. Neurology. 2000;54:1805–10.CrossRefPubMedGoogle Scholar
Kim JS, Choi S, Kwon SU, et al. Inability to control anger or aggression after stroke. Neurology. 2002;58:1106–8.CrossRefPubMedGoogle Scholar
Choi-Kwon S, Han K, Cho KH, et al. Factors associated with post-stroke anger proneness in ischaemic stroke patients. Eur J Neurol. 2013;20:1305–10.CrossRefPubMedGoogle Scholar
Choi-Kwon S, Han SW, Kwon SU, et al. Fluoxetine treatment in poststroke depression, emotional incontinence, and anger proneness: a double-blind, placebo-controlled study. Stroke. 2006;37:156–61.CrossRefPubMedGoogle Scholar
Choi-Kwon S, Kim JS. Poststroke fatigue: an emerging, critical issue in stroke medicine. Int J Stroke. 2011;6:328–36.CrossRefPubMedGoogle Scholar
Klit H, Finnerup NB, Jensen TS. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009;8:857–68.CrossRefPubMedGoogle Scholar
Leijon G, Boivie J. Central post-stroke pain—a controlled trial of amitriptyline and carbamazepine. Pain. 1989;36:27–36.CrossRefPubMedGoogle Scholar
Kim JS, Bashford G, Murphy TK, et al. Safety and efficacy of pregabalin in patients with central post-stroke pain. Pain. 2011;152:1018–23.CrossRefPubMedGoogle Scholar