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Pseudobulbar affect (PBA) is a condition characterized by episodes of sudden, uncontrollable and inappropriate episodes of crying or laughing. The condition can be embarrassing and disruptive to daily life. It typically occurs in people with certain neurological conditions or injuries that affect the way the brain controls emotion. It is common in stroke survivors and people with conditions such as dementia, multiple sclerosis, Lou Gehrig’s disease (ALS) and traumatic brain injury. PBA is thought to affect more than one million people in the United States. The goal of treatment is to reduce the severity and frequency of emotional outbursts. Treatment may include the use of antidepressants and/or a combination of dextromethorphan and quinidine.
Source: GARD Last updated on 05-01-20
The long-term outlook (prognosis) for people with pseudobulbar affect (PBA) may depend on the underlying cause of the condition and any associated condition(s) the affected person has. However, it can have various negative impacts on functioning.
Depending on severity, the condition can be highly disruptive to everyday life, causing distress, embarrassment, social isolation and, in some cases, an inability to work. Some individuals may become housebound or may be moved to supervised living. Unfortunately, the burden of illness associated with PBA is not well characterized. Studies in populations with stroke, Parkinson disease, and other movement disorders have shown that patients with PBA or similarly described symptoms of inappropriate laughing and/or crying have a greater incidence of depression and decreased executive function, sexual function, and ability to perform activities of daily living compared with patients with the same underlying neurological disorder but without PBA symptoms.
Treatment for PBA can reduce the severity and frequency of symptoms. One study involving people with multiple sclerosis and ALS showed that people on medication for PBA had about half as many laughing and crying episodes as did those taking the placebo.
We are not aware of information about whether symptoms of PBA progress, resolve, or remain consistent over time.
Last updated on 05-01-20
The National Multiple Sclerosis Society provides information about Pseudobulbar affect for health professionals.
Last updated on 04-27-20
The National Stroke Association provides information about Pseudobulbar affect.
Last updated on 04-27-20
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