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Pseudobulbar Affect (PBA) impacts the lives of more than two million individuals in the U.S. that we know of, but an additional seven million may be going undiagnosed. Individuals with PBA experience sudden outbursts of uncontrollable laughing or crying – episodes not connected to their actual feelings or fitting to a situation. The impact on quality of life is clear, and with raised awareness and diagnoses, can get better.

PBA occurs as a secondary condition when brain injuries or neurological problems create a disconnect. It can go undiagnosed and under-reported because people coping with or recovering from a stroke, dementia, traumatic brain injury, ALS, MS, or Parkinson’s show a multitude of symptoms. PBA episodes can get mistaken as a symptom of the primary condition, and even worse – mistaken for depression or another mood disorder. Take a moment to consider these characteristics that help differentiate PBA from depression.

Current diagnostic tests for PBA include the Pathological Laughter and Crying Scale and the Center for Neurologic Study-Lability Scale. These are designed to help physicians determine how often and severe PBA outbursts are in a person and pinpoint primary triggers.

A doctor showing a patient a clipboard


There is no cure for PBA, but symptoms can be managed using a multidisciplinary approach. This may include a mix of physical therapy, exercise, and certain medications. Because PBA is a secondary condition and occurs in many co-morbid individuals and/or elderly patients who may be managing other medications and treatments, consider each individual situation carefully.