Pseudobulbar affect, also called PBA, is a brain condition in which a person suddenly starts to laugh or cry and can't manage the reaction. It is a serious neurological condition and the etiology is unknown.
The term pseudobulbar means a condition in the brainstem's corticobulbar pathways that control facial and emotional expression. The corticobulbar tract is composed of the upper motor neurons of the cranial nerves. The muscles of the face, head and neck are controlled by the corticobulbar system.
PBA usually occurs in individuals with certain neurological conditions or injuries that affect how the brain controls emotions.
A major risk factor is traumatic brain injuries.
One of the main signs of pseudobulbar affect is suddenly beginning to cry or laugh when you don't feel sad or find something funny; or those behaviors may be an overreaction to the situation. The reaction may happen at any time and may last for several minutes. You may start laughing, but it often turns into tears. Crying appears to be more common than laughing.
With PBA, you often cannot manage when you laugh or cry. For example, you might laugh too much in response to a mildly amusing comment, or you might laugh or cry at something others don't see as funny or sad. These emotional responses are not how brains would typically react.
Pseudobulbar affect is often mistaken for depression because of the crying. While some people with PBA also may have depression, the two conditions are different. With PBA, crying lasts only a short time. Depression is a feeling of sadness that doesn't go away. People with PBA also do not have problems sleeping or eating, which are common signs of depression.
The exact cause of pseudobulbar affect is not completely understood. While further research is needed, a possible cause of PBA may be an injury to the pathways in the brain that manage how you show emotions. Increases and decreases in certain brain chemicals that send messages between nerve cells also play a role in PBA.
People with certain neurological conditions or injuries have a higher risk of pseudobulbar affect.
Early diagnosis is important. If you or someone you know experiences sudden laughing or crying that doesn't match emotions, talk with a healthcare professional about PBA. Early treatment can help manage symptoms.
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