In the absence of depression, crying spells associated with neurological disease usually result from pseudobulbar palsy or, more rarely, from crying seizures. To our knowledge, there are no prior reports of crying spells heralding or signifying a transient ischaemic attack. We report on a patient with prominent cerebrovascular risk factors who had a transient episode of intractable crying and focal neurological findings.

The patient was a 55 year old right handed man who presented with acute, uncontrolled crying spells followed by left sided paraesthesias. Around 6 00 am he awoke with a diffuse, pressure headache and suddenly started crying for no apparent reason. There was no accompanying feeling of sadness. This crying, which involved lacrimation and “sobbing,” abruptly ceased after 5 minutes. Within 30 minutes of his initial crying spell, his headache had resolved but he became aware of numbness over his left face and numbness and pain in his left neck and arm. The numbness was not progressive, and the patient did not complain of …