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What is PBA? What is PBA?
I was surprised to discover that despite how unknown the condition is, that at least 2 million Americans suffer from PBA... What is PBA?

by Kimberly Allen, RN

If you’re not sure what PBA is then you’re not alone, in fact I must admit when I was asked the other day of I knew what PBA is the only thing that came to mind was Professional Bowlers Association, needless to say that’s not even close.  So I decided to look into it and was quite surprised by what I discovered.  First of all, PBA stands for pseudobulbar affect disorder. There are also numerous other terms that have been used to describe PBA, including pathological laughter and crying which I had heard of.  I was surprised to discover that despite how unknown the condition is, that at least 2 million Americans suffer from PBA.  Although many experts believe that figure to be low as many believe that PBA is not only under diagnosed but also frequently misdiagnosed.

Pseudobulbar Affect Disorder is a condition where a person has unexplained emotional reactions or outbursts, usually laughing or crying.

Pseudobulbar Affect Disorder is a condition where a person has unexplained emotional reactions or outbursts, usually laughing or crying.

PBA is a condition that has known and written about for over 100 years.  PBA is not a condition that can occur independently but is the result of some type of damage done to areas of the brain that is responsible for the voluntary control of emotion.  the damage can be caused by disease or injury.  People suffering from other neurological conditions like MS or ALS as well as people that have had a stroke frequently also suffer from PBA.  Some studies indicate that as much as 52% of stroke victims suffer with PBA after their stroke.  A recent study also indicates that the incidence of PBA in people with traumatic brain injury is approximately 80%.
So what is PBA?  Its a condition where the sufferer experiences and displays sudden bursts of intense emotion, typically laughing or crying.  However, there is rarely an apparent cause and rarely does the emotion displayed represent the sufferer’s true emotions.  These are the people that burst out laughing at funerals or suddenly start crying hysterically for no apparent reason.
Though the exact cause is unknown most experts believe that there is a disruption in the corticobulbar pathways that regulates voluntary emotions caused by bilateral lesions.  There are also some that believe that the damage is in the pre frontal cortex.  though PBA is not life threatening on it’s own it can still have a significant impact on the sufferer’s life.  People with PBA display such sudden and extreme emotional outbursts that they are unable to control that it can cause them to withdraw from family and friends as well as impede their activities of daily living and have an overall negative impact on their health.
Treatment for PBA first requires an accurate diagnosis.  PBA is not depression.  The symptoms differ in that crying in depression is from sadness where as crying from PBA is an involuntary action that is sudden and does not mean the person is sad.  PBA is a disorder involving involuntary behavior so educating your family members as well as friends and co workers about PBA is crucial.  In the past some antidepressants have been used with some success in managing the symptoms of PBA.  However, the FDA recently approved the use of a new drug called Nuedexta which is a combination of dextromethorphan and quinindinefor the treatment of PBA It’s also important for people with PBA to develop a support system to help them cope with the symptoms of PBA as it will help avoid additional complications like depression.
Research on PBA is ongoing and many experts believe that because 80% of people with traumatic brain injury suffer from PBA the incidence will increase as the incidence of traumatic brain injury and it’s complications increases.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at  mussatti3@gmail.com.

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