Pseudobulbar Affect

Pseudobulbar affect (PBA) is a neurological condition that causes outbursts of uncontrolled or inappropriate laughing or crying. These episodes don’t match your internal emotional state. PBA develops as the result of a brain injury or underlying neurological condition, such as amyotrophic lateral sclerosis (ALS).

Although episodes of laughing or crying may seem appropriate for the triggering event (such as seeing or hearing something funny or sad), they tend to be more difficult to restrain. They can also be more intense and last longer than you would ordinarily expect.

PBA may be called several other names, including:

• Emotional lability.
• Pathological laughing and crying.
• Involuntary emotional expression disorder.
• Compulsive laughing or weeping.
• Emotional incontinence.

PBA can have a substantial impact on your life and the lives of your family members and caregivers. It can cause embarrassment and anxiety, leading to withdrawal and social isolation.

How common is pseudobulbar affect?

Researchers estimate that 2 million to 7 million people in the United States have PBA. This range is large because PBA can vary in severity, and it’s often misdiagnosed.

Who does PBA affect?

Pseudobulbar affect (PBA) affects children and adults who have an underlying neurological condition.

Studies estimate that PBA affects:

• Up to 50% of people with amyotrophic lateral sclerosis (ALS).
• Up to 48% of people with traumatic brain injury.
• Up to 46% of people with multiple sclerosis (MS).

Is the pseudobulbar affect a mental illness?

Some people consider PBA a psychiatric disorder (mental illness) since the observable emotional changes (laughing or crying) are associated with mood. However, since PBA results from damaged neurological circuitry in your brain, PBA is best classified as a neuropsychiatric syndrome. In other words, PBA is a brain condition accompanied by dysfunctional emotional expression.