Knowing the signs, causes, and symptoms can help people notice PBA and get treatment to help manage the condition.

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Many cases of PBA go undiagnosed because many people don’t know the condition exists. Knowing the signs, causes, and symptoms can help people notice PBA and get treatment to manage the condition.

PBA can be frustrating for individuals who experience it and for those around them. People with PBA may laugh uncontrollably in response to something that isn’t that funny or they may cry in situations that others don’t see as sad.

Just as no two brain injuries are alike, no two individuals will show PBA in the same way. You or your loved one may have triggering events that cause a laughing or crying response that is disproportionate to the situation in duration or expression. You or your loved one may feel embarrassed or confused. There may be a noticeable display of frustration during an episode. For example, facial expressions or body movements may appear to be spasms.

Feeling overwhelmed, stressed, or anxious is a normal response to the challenges of life, especially when living with a brain injury or other neurological disorder. As PBA can mimic other conditions, it can be difficult to diagnose. That is why it is frequently mistaken for depression. If you suspect you or your loved one has PBA, you can take action.

The Center for Neurologic Study-Lability Scale (CNS-LS) is a short questionnaire that can help individuals with neurologic illness or injury identify the presence of PBA symptoms and their frequency. A CNS-LS score of 13 or higher may suggest PBA, but low and high scores can occur in persons with and without PBA. After a week of tracking, patients can share the questionnaire with their physician. Take the quiz below to determine your CNS-LS score.

Similarly, keeping a detailed journal is helpful when talking with health care providers about PBA symptoms. Keeping track of episodes is important to assist in communicating with your healthcare provider. The PBA Episode Journal (in the PBA Self-Advocacy Toolkit) is a great resource to make sure you capture specific information.


More accurate and timely diagnosis and treatment are possible as awareness of PBA increases.


Frequent, involuntary, and uncontrollable outbursts of crying or laughing that don’t seem appropriate to a given situation.

Outbursts of frustration and anger.

Facial expressions that don’t match emotions.

A “normal” mood between episodes.