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Pseudobulbar Affect in MS

March 15, 2016

Pseudobulbar Affect (PBA) is a condition that is marked by sudden, involuntary episodes of laughing or crying. This is a lesser known, but fairly common symptom of MS, as it affects just over 10% of patients.

PBA is equally common among men and women and occurs in other chronic, neurological conditions such as Parkinson’s disease and amyotrophic lateral sclerosis (ALS). Once it starts, it cannot be controlled voluntarily. This behavior can be extremely distressing as well as embarrassing to those who experience it.

PBA is distinguished from depression by its sudden emotional reactivity. Though depression and PBA both appear to result from the disease process of MS itself, PBA is specifically related to a certain set of behaviors, such as sudden laughing or crying. You could have MS and depression and not experience PBA, or you could have PBA but not have depression. Or you could experience both. The etiology of PBA is unclear and it is believed to be a disorder of mood related to the disruption of nerve impulses in the central nervous system.

Obviously one could take antidepressant medications, but the effectiveness of those medications has not been pinpointed. The only approved treatment, at this time to treat PBA is Nuedexta.