Klazomania in Dementia

[notanumber]

Wasn't sure whether this topic should be in neuro, geri, or psych, so apologies if this sounds misplaced.

Does anyone have information on compulsive screaming in adults with either neuro or psych dx in combination with dementia and/or movement disorders? Not "calling out" as we think of it - compulsive, ear-shattering screaming not associated with pain or fear and not associated with epilepsy due to no loss/alteration of consciousness. Able to suppress temporarily with great difficulty, primarily occurs when alone or not directly engaged. Refractory to medical management. Very unusual and perplexing case with what seems to be a rare and difficult to manage symptom.

[hppygr8ful, ASN, RN, EMT-I]

If it is true Klazomania and not some other neurologic problem then you might find the following article helpful. Otherwise it may be something like Pseudo-bulbar affect disorder when can be treated with the outrageously expensive Newdexta.

Klazomania: A Rare Case of Compulsive Screaming, Complicating Major

Depression, Effectively Treated with Electroconvulsive Therapy (ECT) | Open Access Journals

Hppy

[notanumber]

I can only say that it is the term that best fits the symptom. We are short on geri-psychs and neurologists (well, all MDs, really) in this area and the one in charge of this case isn't particularly invested. I did come across the article you linked. PBA doesn't quite fit - the screaming doesn't occur with crying/teariness/sadness, but it does occur with agitation/anxiety (which is ongoing). The compulsion can be inhibited for short periods, sometimes with self-harm (hand biting), but suppression can heighten agitation. Emotional dysregulation, impulsiveness, poor attention span, and lack of inhibition are also present.

[hppygr8ful, ASN, RN, EMT-I]

I can only say that it is the term that best fits the symptom. We are short on geri-psychs and neurologists (well, all MDs, really) in this area and the one in charge of this case isn't particularly invested. I did come across the article you linked. PBA doesn't quite fit - the screaming doesn't occur with crying/teariness/sadness, but it does occur with agitation/anxiety (which is ongoing). The compulsion can be inhibited for short periods, sometimes with self-harm (hand biting), but suppression can heighten agitation. Emotional dysregulation, impulsiveness, poor attention span, and lack of inhibition are also present.

My own mother had something similar which her psych was calling PDA because although she was not crying or tearful she had extreme emotional dysregulation. She was initially prescribed Nudexta at over $1,000.00 a month but it didn't work. Low dose Seroquel at 25mg TID did the trick. She is now reasonably happy without being gorked out of her mind.

Hppy