PBA Is No Laughing Matter

PseudoBulbar Affect (PBA) is a little-known disorder, but it affects about two million people in the U.S. Those affected are subject to sudden episodes of uncontrollable laughing or crying unrelated to their actual feelings.

Dyanna suffered a stroke five years ago. Afterward, she says, “I started crying or laughing for no reason at all. I wasn’t sad, and there was nothing funny.” Dyanna was often embarrassed, especially in public, but she couldn’t control the episodes.

UCLA Professor of Psychiatry and Aging Dr. Gary Small joins The Doctors to explain PBA. “Post-stroke patients like Dyanna, or people with neurologic conditions like Alzheimer’s, dementia, traumatic brain injury, ALS, MS, and Parkinson’s – they may be at risk for PBA.”

“I was validated and relieved to know that this was not uncommon after a stroke,” says Dyanna, “and that it was manageable.”

ER Physician Dr. Travis Stork explains that expression of emotion, like crying or laughing, are the products of brain signals sent to the body. Brain injuries or neurologic problems can create a disconnect in this system. PBA can be under-reported because patients recovering from a stroke or coping with a neurologic condition may be so consumed with adjusting and managing their symptoms that PBA episodes can go unnoticed.

Dr. Small adds that “Physicians like myself who care for patients with Alzheimer’s and other dementias can have a hard time identifying PBA too. That’s because sudden episodes of crying or laughing can be mistaken for depression or other personality changes associated with dementia.”

Depression is a continuous state of sadness or hopelessness, while the crying and laughing episodes associated with PBA are sudden, brief, and may not represent the patient’s actual emotions.

Avanir Pharmaceuticals has a website, www.pbainfo.org, where visitors can take a PBA assessment and learn more about the condition.

Sponsored by Avanir Pharmaceuticals, Inc.