Pseudobulbar Affect -A neurologic disorder characterised by involuntary crying or
uncontrollable episodes of crying and - or laughing, or other emotional displays.
It is a condition that occurs secondary to neurological chronic condition or brain
injury, and is thought to result from disruptions of neural networks that control
the generation and regulation of motor output of emotions.
Also referred to as:
Labile affect.
Emotional incontinence.
Pathological laughter and crying.
Emotional lability.
Emotionalism.
Emotional dysregulation.
Involuntary emotional expression disorder (IEED).
Forced crying.
Involuntary crying.
Pathological emotionality.
Pseudobulbar affect (PBA) is a distinct neurologic disorder, which can be diagnosed
separately from the underlying chronic condition or injury. Episodes may appear to
be like signs of depression and, as a result the condition is frequently misunderstood.
However, unlike depression, pseudobulbar affect episodes are often sudden, unpredictable,
and may be exaggerated or contrary to the person’s mood.
During a pseudobulbar affect outburst, what a person is expressing on the outside
may not match what they are really feeling on the inside. The emotional display may
be much more intense than their actual inner emotional state. Or it may be the opposite
of how they actually feel.
The condition is commonly observed in people with neurologic injuries and neurological
Conditions such as:
Traumatic Brain Injury.
Stroke.
Dementias including Alzheimer's chronic condition.
The condition will not go away and can cause great embarrassment to a person, impacting
on their life to a point where they may become withdrawn and isolated.
Understanding the condition and being open and frank about may help.
The condition has been observed in association with other disorders such as:
Brain Tumours.
Wilson’s chronic condition.
Syphilitic Pseudobulbar Palsy.
Various Encephalitides.
Gelastic epilepsy.
Dacrystic Epilepsy.
Central Pontine Myelinolysis.
Olivopontinocerebellar Atrophy.
Lipid storage Conditions.
Chemical Exposure.
Fou Rire Prodomique.
The puppetlike syndrome of Angelman.
It is considered that these primary neurologic injuries and Conditions impact chemical
signalling in the brain, which in turn disrupts the neurologic pathways that control
emotional expression.
The symptoms can become severe, with persistent and unremitting episodes.
The onset can be sudden and unpredictable, and have a typical duration of 30 seconds
to 4 minutes.
Outbursts happen typically 4-5 episodes a day; however many may experience as many
as 40-50 episodes per week.
Many may exhibit uncontrollable episodes of laughing, crying and the impact of PBA
can be severe, with unremitting and persistent symptoms that can be disabling to
people, and may significantly impact on the quality of life for caregivers.
