Healthcare: Neurology

Pseudobulbar Affect

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Pseudobulbar affect (PBA) is involuntary and uncontrollable episodes of either laughing or crying that seem inappropriate in the social situation. PBA can cause a great deal of distress in social situations, in the work place, and with family.

The emotion is often triggered by something only slightly funny or sad. For example, a sad TV commercial may trigger uncontrollable crying.

The emotion may also be the opposite emotion that the person is feeling. For example, a fit of uncontrollable laughter may be triggered by feelings of intense anger.

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Prevalence

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Between 43 and 49 percent of individuals with ALS exhibit PBA. PBA is also found in individuals with stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease, and Alzheimer's disease.

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Treatment Options

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Pharmacological

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Nuedexta is currently the only pharmacological treatment approved by the FDA for PBA. Antidepressants, such as amitriptyline, fluoxetine, and citalopram, can also be used to treat PBA.

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Behavioral strategies

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Eliciting the opposite emotion can help control their emotions. For example, during an episode of uncontrollable crying having someone tell a joke can stop the crying spell.