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Pseudobulbar Affect (PBA)

Condition Basics

What is pseudobulbar affect (PBA)?

Pseudobulbar affect (PBA) is a problem in the brain that causes you to laugh or cry for no reason. When you have PBA, sudden fits of tears or laughter can come from nowhere. This behavior usually has nothing to do with what you're doing or feeling. And it's something you can't control. PBA tends to cause awkward social situations. It can make daily living very stressful.

PBA can happen along with certain health problems that affect the brain. Fortunately, there is medicine that can help improve PBA symptoms. Support from people who understand PBA can also help.

What causes it?

Brain damage from a stroke, brain tumor, or head trauma can lead to PBA. PBA can also happen along with such conditions as multiple sclerosis, Parkinson's disease, Alzheimer's disease, ALS, and dementia.

Normally, the "feel" and "express" parts of your brain work together. But with PBA, the expressive part of your brain can trigger behavior on its own. Laughing or crying can happen at any time, no matter what you're feeling.

What are the symptoms?

When you have PBA, you may:

  • Suddenly cry or laugh for no reason.
  • Have trouble controlling how long or intensely you laugh or cry.
  • Feel none of the usual relief after crying or laughing.

How is it diagnosed?

Your doctor can diagnose PBA based on your symptoms and behavior, along with looking at your past health.

PBA is sometimes mistaken for depression or bipolar disorder.

How is pseudobulbar affect (PBA) treated?

PBA is treated with medicine that affects certain brain chemicals. Medicines include:

  • Antidepressant medicine.
  • Dextromethorphan and quinidine (Nuedexta).

Another key to living with PBA is support from people who understand it. Talk with people close to you about your condition. Be patient and kind to yourself. And ask for help when you need it.

Credits

Current as of: August 4, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Colin Chalk MD, CM, FRCPC - Neurology

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