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Pseudobulbar Affect


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Pseudobulbar Affect 

Stroke commonly affects the emotions.  It can cause lack of control of your emotions and an improper response may happen at inappropriate times.  This is called the Pseudobulbar Affect (PBA).  PBA, also known as emotional lability, is a distinct neurologic disorder that causes involuntary crying or uncontrollable episodes of crying and/or laughing, or other emotional displays.

It is estimated that nearly two million Americans suffer with (PBA).  Stroke survivors are just one of several neurologic conditions that suffer with this side-effect.  PBA doesn¨t discriminate. It can affect men and women, old and young.  One of the biggest problems for the stroke survivor is that PBA completely removes the control of their emotions.  Damage can disrupt brain signaling, causing a `short circuit¨, triggering his or her episodes of inappropriate and involuntary crying or laughing.

PBA episodes are typically spontaneous crying or laughing eruptions that do not reflect the way a person is actually feeling. They are inappropriate for a given situation, they are exaggerated, more intense or last longer than the situation calls for.
The good news is that PBA is manageable and treatable.  Below are several tips to use in coping with PBA:
bullet Be open about it - Let people know that you cannot always control your crying or laughing because of a neurologic condition. This can help ensure that people are not surprised, confused or insulted.
bullet Look away and distract yourself - If you feel an episode coming on, look at something else and try to focus on something unrelated.
bullet Breathe - Take slow deep breaths until you are in control.
bullet Relax - Release the tension in your forehead, shoulders, and other muscle groups that tense up during a PBA episode.
bullet Change your body positions - Note the posture you take when having an episode. When you think you are about to cry or laugh, change your position.

If your loved one has PBA, let them know that this is a very common side-effect of stroke.  Tell them that most stroke survivors initially have this side-effect after having one.  You can help by letting that person know you understand that his or her episodes are involuntary and are not something they can control.  Let them know what the tips are for managing this problem.  Talk to their doctor about it.  Anti-depressants have been known, when properly administered, to greatly reduce the degree of PBA.  This, coupled with the above mentioned coping mechanisms can all but make the stroke survivor feel that their PBA episodes are gone.  Time after stroke is another factor with PBA going away. 

Note: If someone you love has PBA, he or she may be embarrassed by his or her outbursts and reluctant to talk about his or her condition.

Stroke Warning Signs

bullet Sudden numbness or weakness of the face, arm or leg, especially on one side of the body   
bullet Sudden confusion, trouble speaking or understanding   
bullet Sudden trouble seeing in one or both eyes   
bullet Sudden trouble walking, dizziness, loss of balance or coordination   
bullet Sudden, severe headache with no known cause

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Original date 3/1/96 Revised 9/24/14