Select a condition to read more about how PBA affects people and their caregivers:

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Stroke

 

Because people recovering from a stroke are often concerned with regaining lost function—and preventing another stroke—it may be easy to overlook sudden, frequent crying and/or laughing symptoms or mistake them for depression.

However, for about a quarter of a million people in the US who have suffered a stroke, these laughing and crying episodes may be PBA.*

According to a survey of 500 stroke patients (or their caregivers), 4.3% may have PBA. Based on this data, 250,000 stroke patients in the United States may have PBA.*

So if you or someone you care for is experiencing uncontrollable crying and/or laughing, you're not alone.

Take the PBA quiz and show the results to your doctor to find out if you or the person you care for might have PBA.

*American Stroke Association and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

Alzheimer's disease or other dementias

 

Alzheimer’s disease and other dementias can make PBA especially hard to spot, since sudden episodes of crying and/or laughing can be mistaken for depression or other personality changes associated with dementia. In addition, people in long-term care settings, like nursing homes, may not have the benefit of a single caretaker who can watch their behavior every day to look for patterns.

Over half a million people in the US with Alzheimer's disease or dementia may have PBA.*

According to a survey of 499 Alzheimer's patients (or their caregivers), 9.6% may have PBA. Based on this data, 500,000 people living with Alzheimer's in the United States may also have PBA.*

So if you have crying and/or laughing symptoms that could be PBA, or you care for someone who might, take the PBA quiz to help your doctor understand what you’ve been experiencing.

 

*National Institute of Neurological Disorders and Stroke (NINDS) and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

Multiple sclerosis (MS)

 

Because MS may produce a wide variety of symptoms—and require different medications to treat them, people with MS who develop episodes of crying or laughing may not always know what's causing them. That's why it's important for patients to describe these episodes to their doctor—how long they last, how the patient feels while they're happening, and how they affect the patient.

In the US, almost 40,000 people with MS may have PBA.*

According to a survey of 504 MS patients (or their caregivers), 9.8% may have PBA. Based on this data, 40,000 MS patients in the United States may have PBA.*

The first step toward accurately diagnosing and treating PBA is learning how to spot it.

Take the PBA quiz and use the Appointment Guide included with your results to help your doctor determine if you or someone you love might have PBA.

*National MS Society and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

Traumatic brain injury

 

Traumatic brain injury (TBI) affects everyone differently. Some experience PBA symptoms of frequent, uncontrollable crying and/or laughing very soon after their injury. While for others, these symptoms may not be recognized until some months after their TBI during the recovery process. Some never experience PBA at all.

According to studies, 800,000 people in the US, or about 15% of those who have suffered a traumatic brain injury, may have PBA.*

According to a survey of 326 TBI patients (or their caregivers), 15% may have PBA. Based on this data, 800,000 TBI patients in the United States may have PBA.*

So if you have TBI and frequent, uncontrollable episodes of crying and/or laughing—or if you care for someone who does—you're not alone. PBA is a treatable condition that hundreds of thousands of people in the US with TBI have experienced.

Take the PBA quiz to help your doctor understand what you’ve been experiencing.

*Centers for Disease Control (CDC) and National Center for Injury Prevention and Control (NCIPC), and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

Parkinson's disease

 

Parkinson's disease is a progressive condition known for its physical symptoms like muscle rigidity, slowed movement, tremors, and problems with posture and balance. Parkinson's disease is often associated with reduced facial expression, so if you have sudden, frequent crying and/or laughing episodes that don't match how you feel inside, this may seem unexpected. While it’s important to make adjustments for physical symptoms, don’t forget to talk to a doctor if you or a loved one also have frequent, uncontrollable crying and/or laughing.

Over 35,000 people in the US with Parkinson's disease may have PBA.*

According to a survey of 449 Parkinson's patients (or their caregivers), 3.6% may have PBA. Based on this data, 35,000 Parkinson's patients in the United States may have PBA.*

Since PBA can be mistaken for depression or other conditions, it’s important to understand how to spot its symptoms.

Take the PBA quiz and share the results with your doctor to see if you or the person you care for might have PBA.

*Parkinson's Disease Foundation and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

ALS (Lou Gehrig’s disease)

 

The symptoms of ALS (Lou Gehrig's disease) can evolve and progress over time. PBA episodes can occur at anytime during the course of ALS and may be mistaken for depression.

Though you may never have heard of PBA, at least 27.5% of people with ALS in the US may have PBA.*

According to a survey of 40 ALS patients (or their caregivers), 27.5% ALS patients in the US may have PBA.*

That means if you or the person you care for might have PBA, you’re not alone.
Take the PBA quiz and share it with your doctor to learn more.

*The ALS Association and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.

  • Stroke
  • Alzheimer's disease or other dementias
  • Multiple sclerosis (MS)
  • Traumatic brain injury (TBI)
  • Parkinson's disease
  • ALS (Lou Gehrig's disease)
 

Even if you’ve never heard of PBA, you’re not alone. PBA is thought to affect about 2 million people in the US who suffer from common neurologic diseases or traumatic brain injuries. It can affect men and women, old and young.

Recognizing PBA

People with PBA experience sudden, frequent, and uncontrollable episodes of crying and/or laughing that may not match up with how they’re feeling inside. These sudden episodes are often: 

Exaggerated
They may be more intense or last longer than expected. For example, a person may cry easily or for a long time after seeing a touching movie or laugh at a joke long after others have stopped.

Mismatched
They may not fit the situation or how the person is feeling. For example, a person might laugh at a funeral or cry when a friend shares good news.

 

PBA is a specific condition distinct from other types of emotional lability that may occur in patients with neurologic disease or injury.

Take the PBA Quiz

Think you or your loved one may have PBA? Answer these 7 questions and share your results with your doctor.

 Take the quiz

The science of PBA

Think of the brain as having circuits. When the circuits work normally:

  • Our thoughts and emotions become signals that travel to the brainstem, or bulb (the “bulbar” part of pseudobulbar affect)
  • These signals help us with expressions of emotion, such as crying and laughing, through face muscles and other body areas

But in people with brain injuries or certain neurologic conditions:

  • Damage can be caused that disrupts some of these signals. That includes signals that tell a person’s body when or how much to cry or laugh
  • This can trigger frequent episodes of crying and/or laughing that are sudden and exaggerated or do not match what a person is feeling inside

The brain's process

PBA

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PBA is NOT…

…depression

People may have both PBA and depression. PBA and depression are separate conditions. Both are treatable and should be diagnosed.

…“just part of your neurologic condition”

PBA is a distinct condition that can occur as a result of an underlying neurologic condition.

…a sign that you are “going crazy”

Many people with this condition are relieved to learn that they are not alone—and their PBA is treatable.

PBA is not a new condition. While it is not fully understood, scientists have known about PBA for quite some time. Over 130 years ago, Charles Darwin wrote that certain brain diseases tend to cause weeping. Over time, many different words have been used to describe problems with laughing, crying, and other displays of emotion following neurologic injury. These include:

  • Emotional lability
  • Emotional incontinence
  • Pathological crying and laughing
  • Involuntary Emotional Expression
    Disorder (IEED)
  • Inappropriate or labile affect

However, PseudoBulbar Affect (PBA) describes specific laughing or crying episodes that are sudden, frequent, uncontrollable, and don't match how you feel.