Materiały źródłowe

• #1 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) involves uncontrolled or inappropriate episodes of laughing or crying. These emotional responses dont match the intensity of your inner feelings. PBA results from certain underlying neurological conditions. Its manageable with medication. […] Pseudobulbar affect (PBA) is a neurological condition that causes outbursts of uncontrolled or inappropriate laughing or crying. These episodes dont match your internal emotional state. PBA develops as the result of a brain injury or underlying neurological condition, such as amyotrophic lateral sclerosis (ALS). […] 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. […] Pseudobulbar affect (PBA) affects children and adults who have an underlying neurological condition.

• #2 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Caring for someone who has it might make you feel confused or frustrated. The emotional toll of the condition can greatly affect recovery and quality of life. It’s important to seek care and treatment from a qualified doctor. […] Doctors might prescribe antidepressants to control PBA symptoms. In 2010, the FDA approved dextromethorphan/quinidine (Nuedexta), the first PBA medication. Studies show it helps control outbursts of crying and laughing in people with MS and ALS. Internists, neuropsychologists, neurologists, and psychiatrists can help diagnose and treat PBA. […] To help you and your loved ones ease anxiety during a PBA episode, and to feel more in control of your health, try these steps: Talk to people around you about PBA and how it affects you and your family. This will help keep them from being surprised or confused when an episode happens. Track your episodes in a diary, including what set them off and how long they lasted. This will help when you talk to your doctor about possible treatments. Talk with other people who have PBA. They understand what its like and might have other tips that might help you. Change your position. If you feel a laughing or crying attack coming on, change how you’re sitting or standing. Breathe slowly and deeply. Keep doing this during an episode until you feel in control. Relax. A flare-up is emotional and can make your muscles tense. Relax your shoulders and forehead after one happens.

• #3 Pseudobulbar affect: prevalence and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3849173/

  Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimers disease, stroke, and brain tumors. […] The psychological consequences and the impact on social interactions may be substantial. […] Although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. […] Recognition of this syndrome and familiarity with its treatment are important aspects of management of patients with a variety of neurological disorders, and provide the clinician with an opportunity to have a positive impact on these patients lives. […] The goal of treatment of PBA is to diminish the severity and frequency of episodes. […] By managing PBA with an appropriate pharmacologic approach, clinicians can have a meaningful impact on symptoms that are socially embarrassing and functionally limiting for these patients.

• #4 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  6 Tips for Caregivers of Pseudobulbar Affect […] If you’ve been caring for a person with a neurological condition like Alzheimer’s disease, you might have noticed sudden laughter or tears. They don’t know why they’re laughing or crying and can’t control it. These episodes are called pseudobulbar affect (PBA). […] Pseudobulbar affect can occur with a condition such as: Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson’s disease, stroke, traumatic brain injury (TBI). […] Although it’s not the same as depression, research from 2020 suggests that PBA is often misdiagnosed as depression. PBA is a neurological condition resulting from changes in the brain that disrupt nerve communication. Understanding PBA may help ensure your loved one gets the correct care.

• #5 Pseudobulbar Affect: Signs, Symptoms, and Treatment for Uncontrollable Laughing or Crying – Neurology Advisor

  https://www.neurologyadvisor.com/features/pseudobulbar-affect-signs-symptoms-and-treatment-for-uncontrollable-laughing-or-crying/

  Pseudobulbar affect is a significant national health issue in the United States, with approximately 2 million individuals affected. […] Pseudobulbar affect (PBA) is a relatively common disorder of emotional expression that occurs in many neurologic disorders including amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, dementia, parkinsonian disorders, brain tumor, and traumatic brain injury. […] Despite the significant prevalence of this disorder, many providers are unaware of or frequently misdiagnose PBA. […] Patients with PBA have no control over when these outbursts will occur or how long they will last. […] Because this disease leads to severe social anxiety, embarrassment, and social isolation, proper diagnosis and appropriate treatment are imperative. […] The goal of treatment of PBA is to diminish the severity and frequency of episodes.

• #6 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  PBA is often misdiagnosed as a psychiatric disorder, such as depression, or underrecognized in patients with conditions whose symptoms mimic those of PBA. […] Patients with PBA may have an appropriate response that is more intense, recurring, and hyperbolic. […] The symptoms can be severe, with persistent, incessant episodes having an abrupt unpredictable onset. […] Symptoms suggestive of PBA in nursing homes present in 17.5% of residents with neurological conditions and 9% of residents overall. […] Caregivers experience a substantial burden when caring for patients with PBA. […] Patients with PBA are aware of social norms and the inappropriateness of their responses. Thus, they are embarrassed by the inability to control these involuntary outbursts. […] Raising awareness of PBA through the education of healthcare professionals, patients, families, caregivers, and the public may result in increased recognition and better management of PBA.

• #7 Pseudobulbar Affect (PBA) | American Stroke Association

  https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects/pseudobulbar-affect

  When the parts of the brain that control emotions are injures, pseudobulbar affect (PBA) occurs. This neurological condition is also known as emotional lability, reflex crying or involuntary emotional expression disorder, among others. […] Those with PBA have involuntary bouts of crying, laughter or anger. The effects are uncontrollable and can occur without an emotional trigger. The outburst may be out of proportion, e.g., something slightly sad yields exaggerated weeping. On the flip side, sad or somber occasions might spur inappropriate laughter. Or there could be rapid switching between laughing and crying. Often there is understanding that the response does not match the feeling. The cause is a neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression.

• #8 When Tears Keep Falling: A Case Report of Pseudobulbar Affect

  https://www.psychiatrist.com/pcc/when-tears-keep-falling-case-report-pseudobulbar-affect/

  In stroke patients, PBA is a common disorder, affecting about 1 in 5 survivors in both acute and post-acute phases and 1 in 8 survivors beyond 6 months post-stroke. […] The likely pathophysiologic mechanism of PBA is the disruption of the cortico-ponto-cerebellar pathway. […] PBA is sometimes misinterpreted as a psychiatric disorder (depressive disorder, bipolar disorder, or posttraumatic stress disorder). […] The only approved pharmacologic treatment for PBA is dextromethorphan and quinidine (none are approved in Portugal for PBA treatment). […] Interdisciplinary work is fundamental in mental illnesses, and neuropsychiatric disorders are a representative paradigm of the necessity of a unified vision of mental disorders.

• #9 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  Pseudobulbar affect (PBA) is a type of affect lability characterized by sudden, frequent, and uncontrollable episodes of crying and/or laughing. […] The treatments utilized for PBA target serotonin, norepinephrine, and glutamate with goals of reducing severity and episode frequency of PBA. […] Recognition of PBA is challenging since many physicians are unaware of the criteria for diagnosis. […] Often, patients are misdiagnosed as having only a depressed mood. […] This is not surprising, as 30% to 35% of patients with PBA are depressed. […] Among those who do discuss these events, only 40% are given a diagnosis of PBA and less than half receive specific treatment. […] The goals of pharmacotherapy are to reduce both the severity and frequency of PBA episodes. […] Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are used in clinical practice, even though the data are limited.

• #10 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  The serotonergic action of SSRIs and TCAs is thought to be significant in the treatment of PBA, as serotonin increases at the synapses in the corticolimbic and cerebellar pathways. […] Pharmacotherapy of PBA may include the use of TCAs, SSRIs, or Nuedexta. […] Pharmacists can provide their expertise by making providers and patients aware of potential drug-drug and/or drug-disease interactions, dose titrations, and tapering strategies, and expectations on how long it may take to see relief in symptoms.

• #11 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) can be difficult to diagnose. Healthcare providers often misdiagnose it as a mood disorder especially depression or bipolar disorder. […] Theres no cure for pseudobulbar affect (PBA), but certain medications can help manage it. The goal of treatment is to reduce the frequency and severity of episodes of laughing or crying. […] Since pseudobulbar affect results from brain damage and neurological conditions, theres nothing you can do to prevent developing it. […] The prognosis (outlook) for PBA varies. […] Medication can help manage symptoms. It may be difficult to receive a diagnosis and treatment, but its important to continue to advocate for yourself. […] Laughing or crying uncontrollably can be challenging, embarrassing and difficult for other people to understand. Know that pseudobulbar affect (PBA) is a medical condition, and its manageable with medication. Talk to a healthcare provider if you develop signs of PBA. Theyre available to help you.

• #12 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  You may find it helpful to see a neurologist, neuropsychologist, or physical medicine and rehab specialist. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism. […] Pseudobulbar affect (PBA) is often misdiagnosed as depression or bipolar disorder. Periods of crying or laughing tend to be shorter in duration in people with PBA than in those with depression. However, depression is common among people who have PBA. […] The following criteria may be used to diagnose pseudobulbar affect: Your emotional response is inconsistent or inappropriate to the situation, unrelated to medication, and not accounted for by any other psychiatric or neurological disorder. Your feelings and your response to those feelings are not related. You cannot control the duration or the severity of episodes of crying or laughing. Expression of emotion does not lead to a feeling of relief.

• #13 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  PBA is often misdiagnosed as a psychiatric disorder, such as depression, or underrecognized in patients with conditions whose symptoms mimic those of PBA. […] Patients with PBA may have an appropriate response that is more intense, recurring, and hyperbolic. […] The symptoms can be severe, with persistent, incessant episodes having an abrupt unpredictable onset. […] Symptoms suggestive of PBA in nursing homes present in 17.5% of residents with neurological conditions and 9% of residents overall. […] Caregivers experience a substantial burden when caring for patients with PBA. […] Patients with PBA are aware of social norms and the inappropriateness of their responses. Thus, they are embarrassed by the inability to control these involuntary outbursts. […] Raising awareness of PBA through the education of healthcare professionals, patients, families, caregivers, and the public may result in increased recognition and better management of PBA.

• #14 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  You may find it helpful to see a neurologist, neuropsychologist, or physical medicine and rehab specialist. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism. […] Pseudobulbar affect (PBA) is often misdiagnosed as depression or bipolar disorder. Periods of crying or laughing tend to be shorter in duration in people with PBA than in those with depression. However, depression is common among people who have PBA. […] The following criteria may be used to diagnose pseudobulbar affect: Your emotional response is inconsistent or inappropriate to the situation, unrelated to medication, and not accounted for by any other psychiatric or neurological disorder. Your feelings and your response to those feelings are not related. You cannot control the duration or the severity of episodes of crying or laughing. Expression of emotion does not lead to a feeling of relief.

• #15 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  You may find it helpful to see a neurologist, neuropsychologist, or physical medicine and rehab specialist. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism. […] Pseudobulbar affect (PBA) is often misdiagnosed as depression or bipolar disorder. Periods of crying or laughing tend to be shorter in duration in people with PBA than in those with depression. However, depression is common among people who have PBA. […] The following criteria may be used to diagnose pseudobulbar affect: Your emotional response is inconsistent or inappropriate to the situation, unrelated to medication, and not accounted for by any other psychiatric or neurological disorder. Your feelings and your response to those feelings are not related. You cannot control the duration or the severity of episodes of crying or laughing. Expression of emotion does not lead to a feeling of relief.

• #16 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  Pseudobulbar affect (PBA) is a type of affect lability characterized by sudden, frequent, and uncontrollable episodes of crying and/or laughing. […] The treatments utilized for PBA target serotonin, norepinephrine, and glutamate with goals of reducing severity and episode frequency of PBA. […] Recognition of PBA is challenging since many physicians are unaware of the criteria for diagnosis. […] Often, patients are misdiagnosed as having only a depressed mood. […] This is not surprising, as 30% to 35% of patients with PBA are depressed. […] Among those who do discuss these events, only 40% are given a diagnosis of PBA and less than half receive specific treatment. […] The goals of pharmacotherapy are to reduce both the severity and frequency of PBA episodes. […] Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are used in clinical practice, even though the data are limited.

• #17 What Is Pseudobulbar Affect? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pseudobulbar-affect/

  Pseudobulbar affect occurs in association with other brain disorders, including amyotrophic lateral sclerosis (ALS), Parkinsons disease, multiple sclerosis (MS), epilepsy, stroke, traumatic brain injury (TBI), and Alzheimers disease. […] Its important to understand the disorder and that the person is not doing anything to contribute to or cause PBA, says Longo. […] PBA is often misdiagnosed or not diagnosed at all. […] PBA is a clinical diagnosis, meaning that the clinician is basing this on the history and observation of the patient, versus a test-based diagnosis, such as a blood test or a brain scan, says Longo. […] If education is not enough, and the PBA is more severe or frequent, the physician has to judge, Is this affecting quality of life and their relationships with their family and their social life?

• #18 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #19 Pseudobulbar Affect: Causes, PBA Quiz, and Management | PBAInfo

  https://www.pbainfo.org/

  Pseudobulbar Affect (PBA) is a medical condition causing sudden, frequent, uncontrollable crying and/or laughing that doesnt match how you feel inside. It can happen in people with a brain injury or certain neurologic conditions. […] Not all healthcare providers are familiar with PBA. Its important to speak to a specialist who has experience in treating PBA. […] Neurologists, psychiatrists, internists, neuropsychiatrists, and physiatrists are types of healthcare providers who may be able to help identify symptoms and properly diagnose PBA. […] If you know or care for someone with PBA, you may be wondering how you can help.

• #20 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  You may find it helpful to see a neurologist, neuropsychologist, or physical medicine and rehab specialist. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism. […] Pseudobulbar affect (PBA) is often misdiagnosed as depression or bipolar disorder. Periods of crying or laughing tend to be shorter in duration in people with PBA than in those with depression. However, depression is common among people who have PBA. […] The following criteria may be used to diagnose pseudobulbar affect: Your emotional response is inconsistent or inappropriate to the situation, unrelated to medication, and not accounted for by any other psychiatric or neurological disorder. Your feelings and your response to those feelings are not related. You cannot control the duration or the severity of episodes of crying or laughing. Expression of emotion does not lead to a feeling of relief.

• #21 Pseudobulbar Affect – Med Center Health

  https://medcenterhealth.org/health-resources/effects-of-stroke/pseudobulbar-affect/

  Pseudobulbar affect (pronounced: su-do-bul-bar aff-ect) or PBA, is also known as emotional lability or emotional incontinence. It can happen after a stroke or traumatic brain injury, or because of neurological conditions such as dementia, Parkinson’s, ALS, and multiple sclerosis. People suffering from PBA experience sudden crying or laughing (or both) that they can’t control. This can cause embarrassment, confusion, frustration and social isolation. […] PBA is under-recognized and under-treated. PBA is diagnosed through a neurological evaluation and the use of standardized questionnaires that measure severity and frequency of crying or laughing episodes. While there is no cure for PBA, the condition can be treated with oral medications. […] If you have suffered a stroke and are frustrated by not being able to control your crying or laughing, talk your doctor about PBA.

• #22 Pseudobulbar affect: prevalence and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3849173/

  Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimers disease, stroke, and brain tumors. […] The psychological consequences and the impact on social interactions may be substantial. […] Although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. […] Recognition of this syndrome and familiarity with its treatment are important aspects of management of patients with a variety of neurological disorders, and provide the clinician with an opportunity to have a positive impact on these patients lives. […] The goal of treatment of PBA is to diminish the severity and frequency of episodes. […] By managing PBA with an appropriate pharmacologic approach, clinicians can have a meaningful impact on symptoms that are socially embarrassing and functionally limiting for these patients.

• #23 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #24 Pseudobulbar affect: Symptoms, tests, and treatment

  https://www.medicalnewstoday.com/articles/pseudobulbar-affect

  Pseudobulbar affect (PBA) involves brief, uncontrolled episodes of crying or laughing. […] Treatment includes drugs that help normalize levels of neurotransmitters in the brain that are too high or too low. […] The goal of treatment for PBA is to decrease the frequency and severity of episodes to improve quality of life. […] Although these are drugs doctors also prescribe for depression, they can also improve the symptoms of other conditions. […] Coping mechanisms, such as deep breathing and using distractions, may also help when episodes are imminent. […] People who experience difficulties with the effects of PBA and neurological conditions may benefit from seeking emotional support from a healthcare professional or support group.

• #25 Pseudobulbar Affect: Signs, Symptoms, and Treatment for Uncontrollable Laughing or Crying – Neurology Advisor

  https://www.neurologyadvisor.com/features/pseudobulbar-affect-signs-symptoms-and-treatment-for-uncontrollable-laughing-or-crying/

  The treatment combines dextromethorphan hydrobromide (20 mg), the ingredient active in the central nervous system, and quinidine sulfate (10 mg), a metabolic inhibitor that enables dextromethorphan to reach therapeutic concentrations. […] Although the mechanisms are not fully understood, serotonergic and glutamatergic transmission appear to play major roles, and there are clear therapeutic benefits in treatment for PBA with SSRIs, TCAs, or dextromethorphan/quinidine. […] With nearly 2 million individuals in the United States experiencing the uncontrollable crying and/or laughing of PBA, this represents a significant national health issue in need of attention from primary care providers.

• #26 NUEDEXTA (dextromethorphan HBr and quinidine sulfate) HCP site

  https://www.nuedextahcp.com/

  Pseudobulbar Affect (PBA) is a neurologic condition characterized by sudden, frequent, and uncontrollable crying and/or laughing, and it can be mistaken for depression. […] NUEDEXTA is indicated for the treatment of pseudobulbar affect (PBA). […] PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurologic disease or injury. […] NUEDEXTA is a combination of dextromethorphan HBr (20 mg) and quinidine sulfate (10 mg) in a capsule. It was proven to significantly reduce PBA episodes. […] PBA episodes can cause immense distress, embarrassment, and confusion for patients.

• #27 NUEDEXTA (dextromethorphan HBr and quinidine sulfate) HCP site

  https://www.nuedextahcp.com/

  Pseudobulbar Affect (PBA) is a neurologic condition characterized by sudden, frequent, and uncontrollable crying and/or laughing, and it can be mistaken for depression. […] NUEDEXTA is indicated for the treatment of pseudobulbar affect (PBA). […] PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurologic disease or injury. […] NUEDEXTA is a combination of dextromethorphan HBr (20 mg) and quinidine sulfate (10 mg) in a capsule. It was proven to significantly reduce PBA episodes. […] PBA episodes can cause immense distress, embarrassment, and confusion for patients.

• #28 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  Pseudobulbar affect (PBA) is a type of affect lability characterized by sudden, frequent, and uncontrollable episodes of crying and/or laughing. […] The treatments utilized for PBA target serotonin, norepinephrine, and glutamate with goals of reducing severity and episode frequency of PBA. […] Recognition of PBA is challenging since many physicians are unaware of the criteria for diagnosis. […] Often, patients are misdiagnosed as having only a depressed mood. […] This is not surprising, as 30% to 35% of patients with PBA are depressed. […] Among those who do discuss these events, only 40% are given a diagnosis of PBA and less than half receive specific treatment. […] The goals of pharmacotherapy are to reduce both the severity and frequency of PBA episodes. […] Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are used in clinical practice, even though the data are limited.

• #29 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  Pseudobulbar affect (PBA) is a type of affect lability characterized by sudden, frequent, and uncontrollable episodes of crying and/or laughing. […] The treatments utilized for PBA target serotonin, norepinephrine, and glutamate with goals of reducing severity and episode frequency of PBA. […] Recognition of PBA is challenging since many physicians are unaware of the criteria for diagnosis. […] Often, patients are misdiagnosed as having only a depressed mood. […] This is not surprising, as 30% to 35% of patients with PBA are depressed. […] Among those who do discuss these events, only 40% are given a diagnosis of PBA and less than half receive specific treatment. […] The goals of pharmacotherapy are to reduce both the severity and frequency of PBA episodes. […] Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are used in clinical practice, even though the data are limited.

• #30 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  Pseudobulbar affect (PBA) describes a disorder that causes a person to experience uncontrollable episodes of crying, laughing, or other emotional displays that are out of context in their social interactions. Typically, pseudobulbar affect occurs secondary to other neurological conditions. […] The impact of pseudobulbar affect is substantial. It can result in embarrassment for people suffering from the disorder, their family, and their caregivers. Pseudobulbar affect may also restrict social interactions causing a lower quality of life. […] Symptoms of pseudobulbar affect can cause anxiety, embarrassment, and social isolation. […] Medications may help if you suffer from pseudobulbar affect. They may include: Antidepressants – tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) may help reduce the frequency and severity of PBA episodes. Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta) – a medication that is designed to specifically treat PBA and is approved by the Food and Drug Administration (FDA).

• #31 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #32 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #33 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #34 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #35 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Caring for someone who has it might make you feel confused or frustrated. The emotional toll of the condition can greatly affect recovery and quality of life. It’s important to seek care and treatment from a qualified doctor. […] Doctors might prescribe antidepressants to control PBA symptoms. In 2010, the FDA approved dextromethorphan/quinidine (Nuedexta), the first PBA medication. Studies show it helps control outbursts of crying and laughing in people with MS and ALS. Internists, neuropsychologists, neurologists, and psychiatrists can help diagnose and treat PBA. […] To help you and your loved ones ease anxiety during a PBA episode, and to feel more in control of your health, try these steps: Talk to people around you about PBA and how it affects you and your family. This will help keep them from being surprised or confused when an episode happens. Track your episodes in a diary, including what set them off and how long they lasted. This will help when you talk to your doctor about possible treatments. Talk with other people who have PBA. They understand what its like and might have other tips that might help you. Change your position. If you feel a laughing or crying attack coming on, change how you’re sitting or standing. Breathe slowly and deeply. Keep doing this during an episode until you feel in control. Relax. A flare-up is emotional and can make your muscles tense. Relax your shoulders and forehead after one happens.

• #36 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #37 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Caring for someone who has it might make you feel confused or frustrated. The emotional toll of the condition can greatly affect recovery and quality of life. It’s important to seek care and treatment from a qualified doctor. […] Doctors might prescribe antidepressants to control PBA symptoms. In 2010, the FDA approved dextromethorphan/quinidine (Nuedexta), the first PBA medication. Studies show it helps control outbursts of crying and laughing in people with MS and ALS. Internists, neuropsychologists, neurologists, and psychiatrists can help diagnose and treat PBA. […] To help you and your loved ones ease anxiety during a PBA episode, and to feel more in control of your health, try these steps: Talk to people around you about PBA and how it affects you and your family. This will help keep them from being surprised or confused when an episode happens. Track your episodes in a diary, including what set them off and how long they lasted. This will help when you talk to your doctor about possible treatments. Talk with other people who have PBA. They understand what its like and might have other tips that might help you. Change your position. If you feel a laughing or crying attack coming on, change how you’re sitting or standing. Breathe slowly and deeply. Keep doing this during an episode until you feel in control. Relax. A flare-up is emotional and can make your muscles tense. Relax your shoulders and forehead after one happens.

• #38

  https://www.geron.org/News-Events/GSA-News/CEO-Blog/pseudobulbar-affect-an-often-overlooked-condition

  Goals of treatment for PBA include reducing severity and frequency of episodes. Behavioral strategies should always be considered for patients and caregivers particularly when symptoms are mild or do not impact the patients quality of life and may be adequate for treatment of PBA. Pharmacologic options may also provide benefit for appropriate patients. Implementing nonpharmacologic behavioral strategies along with pharmacologic treatment may produce a synergistic effect. […] Insights Implications in Gerontology: Understanding Pseudobulbar Affect provides an overview of PBA, reviews goals of treatment for PBA, details treatment of PBA as one aspect of well-coordinated interdisciplinary care for older adults, and offers perspectives from clinicians with experience treating patients with PBA.

• #39

  https://www.geron.org/News-Events/GSA-News/CEO-Blog/pseudobulbar-affect-an-often-overlooked-condition

  Goals of treatment for PBA include reducing severity and frequency of episodes. Behavioral strategies should always be considered for patients and caregivers particularly when symptoms are mild or do not impact the patients quality of life and may be adequate for treatment of PBA. Pharmacologic options may also provide benefit for appropriate patients. Implementing nonpharmacologic behavioral strategies along with pharmacologic treatment may produce a synergistic effect. […] Insights Implications in Gerontology: Understanding Pseudobulbar Affect provides an overview of PBA, reviews goals of treatment for PBA, details treatment of PBA as one aspect of well-coordinated interdisciplinary care for older adults, and offers perspectives from clinicians with experience treating patients with PBA.

• #40 Pseudobulbar Affect: What Nurses, Stroke Survivors, and Caregivers Need to Know – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28125430/

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. In this syndrome, involuntary, uncontrollable, and inappropriate emotional outbursts unrelated or out of proportion to the situation are common symptoms. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

• #41

  https://journals.lww.com/jnnonline/fulltext/2017/04000/pseudobulbar_affect__what_nurses,_stroke.10.aspx

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

• #42 Pseudobulbar Affect: What Nurses, Stroke Survivors, and Caregivers Need to Know – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28125430/

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. In this syndrome, involuntary, uncontrollable, and inappropriate emotional outbursts unrelated or out of proportion to the situation are common symptoms. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

• #43 Pseudobulbar affect: what nurses, stroke Survivors, and caregivers need to know – Document – Gale Academic OneFile

  https://go.gale.com/ps/i.do?id=GALE%7CA491091611&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=08880395&p=AONE&sw=w

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. In this syndrome, involuntary, uncontrollable, and inappropriate emotional outbursts unrelated or out of proportion to the situation are common symptoms. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] This type of emotional instability can cause distress and embarrassment for the person and family/significant others, especially when it happens in the workplace or social situations. […] Worrying about laughing or crying at inappropriate times is a common fear in PBA, and this can negatively impact social functioning. […] Other possible signs include outburst of anger or frustration and emotional lability.

• #44

  https://journals.lww.com/jnnonline/fulltext/2017/04000/pseudobulbar_affect__what_nurses,_stroke.10.aspx

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

• #45

  https://journals.lww.com/jnnonline/fulltext/2017/04000/pseudobulbar_affect__what_nurses,_stroke.10.aspx

  Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. […] The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. […] It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

• #46 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #47 Create a healing environment for patients with pseudobulbar affect

  https://www.myamericannurse.com/healing-environment-pseudobulbar-affect/

  Create a healing environment for patients with pseudobulbar affect. […] Teach patients how to manage PBA for optimal quality of life. […] Pseudobulbar affect (PBA) can develop after a stroke or in conjunction with Alzheimer’s disease, traumatic brain injury, and multiple sclerosis. […] Symptoms include inappropriate emotional responses, sudden emotional outbursts, and facial expressions that don’t match the emotional response. […] PBA treatment includes coping strategies and pharmacologic management. […] Families should be included in care and treatment. […] PBA affects patients physically, socially, and emotionally. Increasing awareness and providing patients and families with ways to manage the disorder are the first steps to creating a healing environment that supports patients in their efforts to overcome the effects of PBA.

• #48 Create a healing environment for patients with pseudobulbar affect

  https://www.myamericannurse.com/healing-environment-pseudobulbar-affect/

  Create a healing environment for patients with pseudobulbar affect. […] Teach patients how to manage PBA for optimal quality of life. […] Pseudobulbar affect (PBA) can develop after a stroke or in conjunction with Alzheimer’s disease, traumatic brain injury, and multiple sclerosis. […] Symptoms include inappropriate emotional responses, sudden emotional outbursts, and facial expressions that don’t match the emotional response. […] PBA treatment includes coping strategies and pharmacologic management. […] Families should be included in care and treatment. […] PBA affects patients physically, socially, and emotionally. Increasing awareness and providing patients and families with ways to manage the disorder are the first steps to creating a healing environment that supports patients in their efforts to overcome the effects of PBA.

• #49 Create a healing environment for patients with pseudobulbar affect

  https://www.myamericannurse.com/healing-environment-pseudobulbar-affect/

  Create a healing environment for patients with pseudobulbar affect. […] Teach patients how to manage PBA for optimal quality of life. […] Pseudobulbar affect (PBA) can develop after a stroke or in conjunction with Alzheimer’s disease, traumatic brain injury, and multiple sclerosis. […] Symptoms include inappropriate emotional responses, sudden emotional outbursts, and facial expressions that don’t match the emotional response. […] PBA treatment includes coping strategies and pharmacologic management. […] Families should be included in care and treatment. […] PBA affects patients physically, socially, and emotionally. Increasing awareness and providing patients and families with ways to manage the disorder are the first steps to creating a healing environment that supports patients in their efforts to overcome the effects of PBA.

• #50 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #51 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Caring for someone who has it might make you feel confused or frustrated. The emotional toll of the condition can greatly affect recovery and quality of life. It’s important to seek care and treatment from a qualified doctor. […] Doctors might prescribe antidepressants to control PBA symptoms. In 2010, the FDA approved dextromethorphan/quinidine (Nuedexta), the first PBA medication. Studies show it helps control outbursts of crying and laughing in people with MS and ALS. Internists, neuropsychologists, neurologists, and psychiatrists can help diagnose and treat PBA. […] To help you and your loved ones ease anxiety during a PBA episode, and to feel more in control of your health, try these steps: Talk to people around you about PBA and how it affects you and your family. This will help keep them from being surprised or confused when an episode happens. Track your episodes in a diary, including what set them off and how long they lasted. This will help when you talk to your doctor about possible treatments. Talk with other people who have PBA. They understand what its like and might have other tips that might help you. Change your position. If you feel a laughing or crying attack coming on, change how you’re sitting or standing. Breathe slowly and deeply. Keep doing this during an episode until you feel in control. Relax. A flare-up is emotional and can make your muscles tense. Relax your shoulders and forehead after one happens.

• #52 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  The serotonergic action of SSRIs and TCAs is thought to be significant in the treatment of PBA, as serotonin increases at the synapses in the corticolimbic and cerebellar pathways. […] Pharmacotherapy of PBA may include the use of TCAs, SSRIs, or Nuedexta. […] Pharmacists can provide their expertise by making providers and patients aware of potential drug-drug and/or drug-disease interactions, dose titrations, and tapering strategies, and expectations on how long it may take to see relief in symptoms.

• #53 Caregiving for PBA | PBAinfo

  https://www.pbainfo.org/caregiving-pba

  Youre a caregiver. […] When someone you love may have Pseudobulbar Affect (PBA), youre in a special positionthe position to help make an impact. […] Laura is a real caregiver, and Amy is a real patient living with PBA. […] Marilyn is a real caregiver, and Jim is a real patient living with PBA. […] Observe the impact PBA episodes have on your loved ones life. […] Share details with their healthcare provider. It could be critical to making an accurate PBA diagnosis. […] Encourage your loved one to make an appointment with a healthcare provider. […] Discuss with a healthcare provider the impact your loved ones episodes have had on their daily routines. […] Marilyn helps Jim by being accepting and supportive of his condition, which has helped him remain social. […] I think at first he thought it was embarrassing for me and I told him its not. […] Laura has been a consistent support for Amy though phone calls, texts, and frequent visits. […] It was hard to understand why she was acting so different.

• #54 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #55 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #56 Caregiving for PBA | PBAinfo

  https://www.pbainfo.org/caregiving-pba

  Youre a caregiver. […] When someone you love may have Pseudobulbar Affect (PBA), youre in a special positionthe position to help make an impact. […] Laura is a real caregiver, and Amy is a real patient living with PBA. […] Marilyn is a real caregiver, and Jim is a real patient living with PBA. […] Observe the impact PBA episodes have on your loved ones life. […] Share details with their healthcare provider. It could be critical to making an accurate PBA diagnosis. […] Encourage your loved one to make an appointment with a healthcare provider. […] Discuss with a healthcare provider the impact your loved ones episodes have had on their daily routines. […] Marilyn helps Jim by being accepting and supportive of his condition, which has helped him remain social. […] I think at first he thought it was embarrassing for me and I told him its not. […] Laura has been a consistent support for Amy though phone calls, texts, and frequent visits. […] It was hard to understand why she was acting so different.

• #57 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #58 Caregiving for PBA | PBAinfo

  https://www.pbainfo.org/caregiving-pba

  Youre a caregiver. […] When someone you love may have Pseudobulbar Affect (PBA), youre in a special positionthe position to help make an impact. […] Laura is a real caregiver, and Amy is a real patient living with PBA. […] Marilyn is a real caregiver, and Jim is a real patient living with PBA. […] Observe the impact PBA episodes have on your loved ones life. […] Share details with their healthcare provider. It could be critical to making an accurate PBA diagnosis. […] Encourage your loved one to make an appointment with a healthcare provider. […] Discuss with a healthcare provider the impact your loved ones episodes have had on their daily routines. […] Marilyn helps Jim by being accepting and supportive of his condition, which has helped him remain social. […] I think at first he thought it was embarrassing for me and I told him its not. […] Laura has been a consistent support for Amy though phone calls, texts, and frequent visits. […] It was hard to understand why she was acting so different.

• #59 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #60 Caregiving for PBA | Nuedexta

  https://www.nuedexta.com/caregiving-for-pba

  Caring for someone living with a neurological disorder or brain injury can be difficult. […] However, if you are observing episodes of uncontrollable crying and/or laughing that are sudden, frequent, confusing, disruptive, and either exaggerated or mismatched to the situation, it could be a sign of PBA. Pseudobulbar Affect (PBA) is common in people with certain neurological conditions or brain injury. PBA is a neurologic disorder caused by damage in the brain that impacts the expression of emotion. […] As a caregiver, you play an important role in your loved ones care team and are in a special position to help make an impact. If you think your loved one may have PBA, take these steps to be a critical advocate: Learn about PBA and how its different from depression. Observe and document your loved ones episodes and the impact they have. Advocate for your loved one at healthcare appointments. Seek treatment for your loved one and support their treatment plan.

• #61 Caregiving for PBA | PBAinfo

  https://www.pbainfo.org/caregiving-pba

  Youre a caregiver. […] When someone you love may have Pseudobulbar Affect (PBA), youre in a special positionthe position to help make an impact. […] Laura is a real caregiver, and Amy is a real patient living with PBA. […] Marilyn is a real caregiver, and Jim is a real patient living with PBA. […] Observe the impact PBA episodes have on your loved ones life. […] Share details with their healthcare provider. It could be critical to making an accurate PBA diagnosis. […] Encourage your loved one to make an appointment with a healthcare provider. […] Discuss with a healthcare provider the impact your loved ones episodes have had on their daily routines. […] Marilyn helps Jim by being accepting and supportive of his condition, which has helped him remain social. […] I think at first he thought it was embarrassing for me and I told him its not. […] Laura has been a consistent support for Amy though phone calls, texts, and frequent visits. […] It was hard to understand why she was acting so different.

• #62 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Your loved one might cry or laugh at an unexpected time. You can navigate the experience by remembering what’s happening. They’re not laughing at you or anyone else. Similarly, they’re not crying because they’re sad over something happening at that exact moment. It’s in response to a nervous system disorder, and they cannot control when the episodes occur. […] Your loved one might get upset about crying or laughing unexpectedly. If that happens, you can try to comfort them and reassure them. You can help them find a quiet place to recover from the episode if they prefer. […] You might also track PBA episodes to see what might prompt the crying or laughing. If you notice trends, make a note. Now you can watch out for those potential triggers. […] People who experience PBA are sometimes embarrassed when they begin to laugh or cry uncontrollably in public. Explaining to others about the condition may help.

• #63 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  The key to delivering effective care and support is comprehending the root of those occurrences. The individual may display emotional responses at unexpected moments. You can manage these situations by being empathetic to the underlying cause. They are not expressing these emotions towards anyone intentionally. The episodes are not a result of an immediate event but a consequence of a nervous system disorder over which they have no control. […] These unexpected emotional episodes might distress your loved one. In such situations, offering comfort and reassurance can be beneficial. If preferred, guide them to a peaceful setting to recover. Encourage them to practice breathing techniques or engage in physical movement to alleviate the intensity of their emotions. […] Observing and noting potential patterns preceding emotional outbursts may help you identify triggers. Your role as a caregiver is crucial in this process. By doing so, you can effectively anticipate and mitigate potential causes. Additionally, encouraging your loved one to track their episodes can assist in identifying triggers.

• #64 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Your loved one might cry or laugh at an unexpected time. You can navigate the experience by remembering what’s happening. They’re not laughing at you or anyone else. Similarly, they’re not crying because they’re sad over something happening at that exact moment. It’s in response to a nervous system disorder, and they cannot control when the episodes occur. […] Your loved one might get upset about crying or laughing unexpectedly. If that happens, you can try to comfort them and reassure them. You can help them find a quiet place to recover from the episode if they prefer. […] You might also track PBA episodes to see what might prompt the crying or laughing. If you notice trends, make a note. Now you can watch out for those potential triggers. […] People who experience PBA are sometimes embarrassed when they begin to laugh or cry uncontrollably in public. Explaining to others about the condition may help.

• #65 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  The key to delivering effective care and support is comprehending the root of those occurrences. The individual may display emotional responses at unexpected moments. You can manage these situations by being empathetic to the underlying cause. They are not expressing these emotions towards anyone intentionally. The episodes are not a result of an immediate event but a consequence of a nervous system disorder over which they have no control. […] These unexpected emotional episodes might distress your loved one. In such situations, offering comfort and reassurance can be beneficial. If preferred, guide them to a peaceful setting to recover. Encourage them to practice breathing techniques or engage in physical movement to alleviate the intensity of their emotions. […] Observing and noting potential patterns preceding emotional outbursts may help you identify triggers. Your role as a caregiver is crucial in this process. By doing so, you can effectively anticipate and mitigate potential causes. Additionally, encouraging your loved one to track their episodes can assist in identifying triggers.

• #66 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Your loved one might cry or laugh at an unexpected time. You can navigate the experience by remembering what’s happening. They’re not laughing at you or anyone else. Similarly, they’re not crying because they’re sad over something happening at that exact moment. It’s in response to a nervous system disorder, and they cannot control when the episodes occur. […] Your loved one might get upset about crying or laughing unexpectedly. If that happens, you can try to comfort them and reassure them. You can help them find a quiet place to recover from the episode if they prefer. […] You might also track PBA episodes to see what might prompt the crying or laughing. If you notice trends, make a note. Now you can watch out for those potential triggers. […] People who experience PBA are sometimes embarrassed when they begin to laugh or cry uncontrollably in public. Explaining to others about the condition may help.

• #67 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  The key to delivering effective care and support is comprehending the root of those occurrences. The individual may display emotional responses at unexpected moments. You can manage these situations by being empathetic to the underlying cause. They are not expressing these emotions towards anyone intentionally. The episodes are not a result of an immediate event but a consequence of a nervous system disorder over which they have no control. […] These unexpected emotional episodes might distress your loved one. In such situations, offering comfort and reassurance can be beneficial. If preferred, guide them to a peaceful setting to recover. Encourage them to practice breathing techniques or engage in physical movement to alleviate the intensity of their emotions. […] Observing and noting potential patterns preceding emotional outbursts may help you identify triggers. Your role as a caregiver is crucial in this process. By doing so, you can effectively anticipate and mitigate potential causes. Additionally, encouraging your loved one to track their episodes can assist in identifying triggers.

• #68 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Your loved one might cry or laugh at an unexpected time. You can navigate the experience by remembering what’s happening. They’re not laughing at you or anyone else. Similarly, they’re not crying because they’re sad over something happening at that exact moment. It’s in response to a nervous system disorder, and they cannot control when the episodes occur. […] Your loved one might get upset about crying or laughing unexpectedly. If that happens, you can try to comfort them and reassure them. You can help them find a quiet place to recover from the episode if they prefer. […] You might also track PBA episodes to see what might prompt the crying or laughing. If you notice trends, make a note. Now you can watch out for those potential triggers. […] People who experience PBA are sometimes embarrassed when they begin to laugh or cry uncontrollably in public. Explaining to others about the condition may help.

• #69 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  The key to delivering effective care and support is comprehending the root of those occurrences. The individual may display emotional responses at unexpected moments. You can manage these situations by being empathetic to the underlying cause. They are not expressing these emotions towards anyone intentionally. The episodes are not a result of an immediate event but a consequence of a nervous system disorder over which they have no control. […] These unexpected emotional episodes might distress your loved one. In such situations, offering comfort and reassurance can be beneficial. If preferred, guide them to a peaceful setting to recover. Encourage them to practice breathing techniques or engage in physical movement to alleviate the intensity of their emotions. […] Observing and noting potential patterns preceding emotional outbursts may help you identify triggers. Your role as a caregiver is crucial in this process. By doing so, you can effectively anticipate and mitigate potential causes. Additionally, encouraging your loved one to track their episodes can assist in identifying triggers.

• #70 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Your loved one might cry or laugh at an unexpected time. You can navigate the experience by remembering what’s happening. They’re not laughing at you or anyone else. Similarly, they’re not crying because they’re sad over something happening at that exact moment. It’s in response to a nervous system disorder, and they cannot control when the episodes occur. […] Your loved one might get upset about crying or laughing unexpectedly. If that happens, you can try to comfort them and reassure them. You can help them find a quiet place to recover from the episode if they prefer. […] You might also track PBA episodes to see what might prompt the crying or laughing. If you notice trends, make a note. Now you can watch out for those potential triggers. […] People who experience PBA are sometimes embarrassed when they begin to laugh or cry uncontrollably in public. Explaining to others about the condition may help.

• #71 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  Individuals experiencing PBA may feel embarrassed or misunderstood in public. Educating others about the condition could help alleviate these feelings and reduce the stigma associated with PBA. While it may not be possible to inform everyone, educating those regularly in contact with the individual can foster understanding and support. […] Discuss potential treatments with your loved one’s healthcare providers. While in the past, there weren’t tailored medical treatments, the approval of Nuedexta by the Food and Drug Administration (FDA) provided a viable option. Nuedexta, a medication specifically designed to treat PBA, can aid in reducing the frequency and intensity of emotional episodes. Other treatment options, such as counseling and therapy, may also be beneficial and should be discussed with healthcare providers.

• #72 Tips for Pseudobulbar Affect Caregivers

  https://resources.healthgrades.com/right-care/brain-and-nerves/6-tips-for-caregivers-of-pseudobulbar-affect

  Consider talking with your loved one’s doctors about possible treatments. Until a few years ago, there wasn’t a medical treatment for PBA. However, the Food and Drug Administration (FDA) approved Nuedexta (dextromethorphan, hydrobromide, and quinidine sulfate) to treat PBA. Nuedexta can help reduce the number and intensity of crying and laughing episodes. […] Many associations — both online and in person — offer support for caregivers. A caregiver support group can help you feel less alone.

• #73 Path to Caring for PBA – White Glove Community Care

  https://whiteglovehomecare.com/path-to-caring-for-pba-pseudobulbar-affect/

  Numerous organizations, both online and in physical communities, offer support for caregivers. Participation in a caregiver support group can provide a sense of understanding and belonging. Depending on your loved one’s specific condition, consider contacting relevant organizations and exploring support groups or peer mentoring programs recommended by their doctor.

• #74 PBA Resources for Caregivers – PBA Voices

  https://pbavoices.org/resources/caregivers/

  Raise awareness about PBA – Talk with family and friends about what it is, what to expect, and what they can do if they know someone impacted by PBA. […] Take care of yourself – Go for a walk, try a relaxation technique like meditation or breathing exercises, listen to music, or enjoy a cup of tea. […] Manage your time – Logistics, schedules, appointments and errands – caregiving and otherwise – add up. Get and stay organized! Try an app, use the notepad on your mobile device, or keep a tried-and-true hard copy datebook or paper calendar. […] Seek out other caregivers to build your own support network – online or in-person. […] The PBA Self-Advocacy Toolkit includes: […] Tips on how to live with and care for someone with PBA.

• #75 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) involves uncontrolled or inappropriate episodes of laughing or crying. These emotional responses dont match the intensity of your inner feelings. PBA results from certain underlying neurological conditions. Its manageable with medication. […] Pseudobulbar affect (PBA) is a neurological condition that causes outbursts of uncontrolled or inappropriate laughing or crying. These episodes dont match your internal emotional state. PBA develops as the result of a brain injury or underlying neurological condition, such as amyotrophic lateral sclerosis (ALS). […] 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. […] Pseudobulbar affect (PBA) affects children and adults who have an underlying neurological condition.

• #76 Pseudobulbar affect – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/symptoms-causes/syc-20353737

  Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. […] Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication. […] If you think you have PBA, talk to your doctor. If you have a neurological condition, you might already be treated by a doctor who can diagnose PBA. […] Severe symptoms of pseudobulbar affect (PBA) can cause embarrassment, social isolation, anxiety and depression. The condition might interfere with your ability to work and do daily tasks, especially when you’re already coping with a neurological condition.

• #77 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  Pseudobulbar affect (PBA) describes a disorder that causes a person to experience uncontrollable episodes of crying, laughing, or other emotional displays that are out of context in their social interactions. Typically, pseudobulbar affect occurs secondary to other neurological conditions. […] The impact of pseudobulbar affect is substantial. It can result in embarrassment for people suffering from the disorder, their family, and their caregivers. Pseudobulbar affect may also restrict social interactions causing a lower quality of life. […] Symptoms of pseudobulbar affect can cause anxiety, embarrassment, and social isolation. […] Medications may help if you suffer from pseudobulbar affect. They may include: Antidepressants – tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) may help reduce the frequency and severity of PBA episodes. Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta) – a medication that is designed to specifically treat PBA and is approved by the Food and Drug Administration (FDA).

• #78

  https://www.geron.org/News-Events/GSA-News/CEO-Blog/pseudobulbar-affect-an-often-overlooked-condition

  Understanding Pseudobulbar Affect, the inaugural publication of the new Insights Implications in Gerontology series from The Gerontological Society of America, addresses an often overlooked or misunderstood condition that has the potential to lead to decreased quality of life for older adults and their caregivers. […] PBA symptoms can cause embarrassment for older adults and their family and caregivers resulting in restricted social interactions, withdrawal, and social isolation. Thus, older adults with neurologic disorders and PBA experience additional burden of disease and reduced quality of life. […] Care providers (including family members and staff at long-term care facilities who observe patients laughing or crying inappropriately) may consider having the patient evaluated for PBA, especially if the patient has a neurologic condition or brain injury.

• #79 Pseudobulbar affect | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20192124/

  Pseudobulbar affect (PBA) is a condition thats characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. […] Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication. […] Severe symptoms of pseudobulbar affect (PBA) can cause embarrassment, social isolation, anxiety and depression. The condition might interfere with your ability to work and do daily tasks, especially when youre already coping with a neurological condition. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with psedobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they arent surprised or confused by your behavior.

• #80 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) involves uncontrolled or inappropriate episodes of laughing or crying. These emotional responses dont match the intensity of your inner feelings. PBA results from certain underlying neurological conditions. Its manageable with medication. […] Pseudobulbar affect (PBA) is a neurological condition that causes outbursts of uncontrolled or inappropriate laughing or crying. These episodes dont match your internal emotional state. PBA develops as the result of a brain injury or underlying neurological condition, such as amyotrophic lateral sclerosis (ALS). […] 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. […] Pseudobulbar affect (PBA) affects children and adults who have an underlying neurological condition.

• #81 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  Pseudobulbar affect (PBA) describes a disorder that causes a person to experience uncontrollable episodes of crying, laughing, or other emotional displays that are out of context in their social interactions. Typically, pseudobulbar affect occurs secondary to other neurological conditions. […] The impact of pseudobulbar affect is substantial. It can result in embarrassment for people suffering from the disorder, their family, and their caregivers. Pseudobulbar affect may also restrict social interactions causing a lower quality of life. […] Symptoms of pseudobulbar affect can cause anxiety, embarrassment, and social isolation. […] Medications may help if you suffer from pseudobulbar affect. They may include: Antidepressants – tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) may help reduce the frequency and severity of PBA episodes. Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta) – a medication that is designed to specifically treat PBA and is approved by the Food and Drug Administration (FDA).

• #82 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  Pseudobulbar affect (PBA), despite its prevalence and distinctive symptoms, is widely underrecognized and undertreated. […] PBA is thought to center around preexisting neurological conditions, which include Parkinson disease, multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, traumatic brain injury, and stroke. […] Through greater awareness, recognition, and diagnosis, treatment for patients with PBA can be improved. […] PBA occurs most commonly among patients who have PD, multiple sclerosis, amyotrophic lateral sclerosis or AD or have experienced a traumatic brain injury, stroke and other neurological diseases that damage the central nervous system. […] Patients and caregivers report experiencing embarrassment and a decreased quality of life, which may lead to disruptions in their social lives, including isolation and loss of employment.

• #83 What Is Pseudobulbar Affect? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pseudobulbar-affect/

  Its very helpful to understand PBA, because if you observe it without having seen it before or knowing anything about it, its stressful to see, says Longo. […] PBA can keep people away from work, volunteering, or other opportunities for social interaction, further adding to feelings of loneliness and alienation, he says.

• #84 Enhancing Approaches to the Identification and Management of Pseudobulbar Affect

  https://www.psychiatrist.com/jcp/enhancing-approaches-identification-management-pseudobulbar/

  Pseudobulbar affect (PBA) is a socially debilitating condition that primarily affects people with neurologic diseases, such as Alzheimers disease or multiple sclerosis. […] Treatment of PBA has traditionally centered on antidepressant therapies, but newer therapeutic options include combination agents employing multiple modalities. Therapy should include patient counseling to reassure patients and families that PBA is not the fault of the individual. Counseling should also emphasize safety precautions to minimize adverse events and maximize appropriate adherence to the selected therapies. […] PBA is an added burden to the significant difficulty of coping with a neurologic disease, making recognition and treatment important. Treatment options for PBA historically have centered on the antidepressant categories, including tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).

• #85 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #86 Pseudobulbar affect | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20192124/

  Pseudobulbar affect (PBA) is a condition thats characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. […] Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication. […] Severe symptoms of pseudobulbar affect (PBA) can cause embarrassment, social isolation, anxiety and depression. The condition might interfere with your ability to work and do daily tasks, especially when youre already coping with a neurological condition. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with psedobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they arent surprised or confused by your behavior.

• #87 Pseudobulbar affect // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. […] Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. Medication options include: […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] Talking to other people who have PBA also might help you feel understood and give you a chance to discuss tips for coping with the condition.

• #88 Pseudobulbar affect – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/diagnosis-treatment/drc-20353741

  Pseudobulbar affect (PBA) is typically diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists and psychiatrists. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with pseudobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they aren’t surprised or confused by your behavior. […] To cope with an episode: Distract yourself, Take slow, deep breaths, Relax your body, Change your position. […] Use a notebook to jot down details about your emotional outbursts. […] Be prepared to discuss any major stresses or recent life changes.

• #89 Pseudobulbar affect | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20192124/

  Pseudobulbar affect (PBA) is a condition thats characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. […] Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication. […] Severe symptoms of pseudobulbar affect (PBA) can cause embarrassment, social isolation, anxiety and depression. The condition might interfere with your ability to work and do daily tasks, especially when youre already coping with a neurological condition. […] The goal of treatment for pseudobulbar affect (PBA) is to reduce the severity and frequency of emotional outbursts. […] An occupational therapist also can help you develop ways to complete everyday tasks despite your PBA. […] Living with psedobulbar affect (PBA) can be embarrassing and stressful. It might help to explain to family, friends and co-workers how the condition affects you, so they arent surprised or confused by your behavior.

• #90

• #91 Learning About Pseudobulbar Affect (PBA) | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-pseudobulbar-affect-pba.abr9372

  PBA can happen along with certain health problems that affect the brain, such as Parkinson’s disease or damage from a stroke. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Having PBA can be frustrating. Try to be patient and kind to yourself. Talk with people close to you about your condition. Ask for help when you need it. Consider joining a support group. It can help to talk to others who are dealing with the same problem.

• #92

• #93 Learning About Pseudobulbar Affect (PBA) | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-pseudobulbar-affect-pba.abr9372

  PBA can happen along with certain health problems that affect the brain, such as Parkinson’s disease or damage from a stroke. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Having PBA can be frustrating. Try to be patient and kind to yourself. Talk with people close to you about your condition. Ask for help when you need it. Consider joining a support group. It can help to talk to others who are dealing with the same problem.

• #94 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  Pseudobulbar affect (PBA) is a distressing neurologic condition that occurs secondary to brain injury or underlying neurologic disease affecting the brain. A recent study found that 9% of nursing home residents had symptoms suggestive of PBA and were receiving more psychiatric medications than those without symptoms. […] Improving the diagnosis of PBA may help optimize the management of this underrecognized and underdiagnosed condition and potentially reduce unnecessary medication burden. […] Neurologic conditions, particularly stroke, AD, and PD, are common in nursing home residents, but the prevalence of PBA symptoms in nursing home residents had never been formally measured until recently. […] Results of the study, published in the International Journal of Geriatric Psychiatry in November 2015, found that more than one-half of the nursing home residents (412 or 51%) had a predisposing neurologic condition known to be associated with PBA (eg, PD, AD, stroke, TBI, MS, or ALS).

• #95 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  PBA is often misdiagnosed as a psychiatric disorder, such as depression, or underrecognized in patients with conditions whose symptoms mimic those of PBA. […] Patients with PBA may have an appropriate response that is more intense, recurring, and hyperbolic. […] The symptoms can be severe, with persistent, incessant episodes having an abrupt unpredictable onset. […] Symptoms suggestive of PBA in nursing homes present in 17.5% of residents with neurological conditions and 9% of residents overall. […] Caregivers experience a substantial burden when caring for patients with PBA. […] Patients with PBA are aware of social norms and the inappropriateness of their responses. Thus, they are embarrassed by the inability to control these involuntary outbursts. […] Raising awareness of PBA through the education of healthcare professionals, patients, families, caregivers, and the public may result in increased recognition and better management of PBA.

• #96 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  This finding translated to a potential prevalence of PBA of 17.5% in the predisposed population (those with neurologic disorders and without psychosis or disruptive behavior) and 9% among all nursing home residents. […] The study also found that residents with PBA symptoms were more likely to be using antipsychotics, as well as anxiolytics and antidepressants. […] Identifying and managing PBA can be challenging for clinicians because it is underrecognized and the symptoms overlap with those of depression and other psychiatric disorders. […] Therefore, avoiding unnecessary medication use is recommended. This is particularly important in patients with PBA, where other treatment options are available. These findings underscore the importance of more accurate diagnosis of PBA.

• #97 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  This finding translated to a potential prevalence of PBA of 17.5% in the predisposed population (those with neurologic disorders and without psychosis or disruptive behavior) and 9% among all nursing home residents. […] The study also found that residents with PBA symptoms were more likely to be using antipsychotics, as well as anxiolytics and antidepressants. […] Identifying and managing PBA can be challenging for clinicians because it is underrecognized and the symptoms overlap with those of depression and other psychiatric disorders. […] Therefore, avoiding unnecessary medication use is recommended. This is particularly important in patients with PBA, where other treatment options are available. These findings underscore the importance of more accurate diagnosis of PBA.

• #98 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  Pseudobulbar affect (PBA) is a distressing neurologic condition that occurs secondary to brain injury or underlying neurologic disease affecting the brain. A recent study found that 9% of nursing home residents had symptoms suggestive of PBA and were receiving more psychiatric medications than those without symptoms. […] Improving the diagnosis of PBA may help optimize the management of this underrecognized and underdiagnosed condition and potentially reduce unnecessary medication burden. […] Neurologic conditions, particularly stroke, AD, and PD, are common in nursing home residents, but the prevalence of PBA symptoms in nursing home residents had never been formally measured until recently. […] Results of the study, published in the International Journal of Geriatric Psychiatry in November 2015, found that more than one-half of the nursing home residents (412 or 51%) had a predisposing neurologic condition known to be associated with PBA (eg, PD, AD, stroke, TBI, MS, or ALS).

• #99 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  This finding translated to a potential prevalence of PBA of 17.5% in the predisposed population (those with neurologic disorders and without psychosis or disruptive behavior) and 9% among all nursing home residents. […] The study also found that residents with PBA symptoms were more likely to be using antipsychotics, as well as anxiolytics and antidepressants. […] Identifying and managing PBA can be challenging for clinicians because it is underrecognized and the symptoms overlap with those of depression and other psychiatric disorders. […] Therefore, avoiding unnecessary medication use is recommended. This is particularly important in patients with PBA, where other treatment options are available. These findings underscore the importance of more accurate diagnosis of PBA.

• #100 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  Pseudobulbar affect (PBA) is a distressing neurologic condition that occurs secondary to brain injury or underlying neurologic disease affecting the brain. A recent study found that 9% of nursing home residents had symptoms suggestive of PBA and were receiving more psychiatric medications than those without symptoms. […] Improving the diagnosis of PBA may help optimize the management of this underrecognized and underdiagnosed condition and potentially reduce unnecessary medication burden. […] Neurologic conditions, particularly stroke, AD, and PD, are common in nursing home residents, but the prevalence of PBA symptoms in nursing home residents had never been formally measured until recently. […] Results of the study, published in the International Journal of Geriatric Psychiatry in November 2015, found that more than one-half of the nursing home residents (412 or 51%) had a predisposing neurologic condition known to be associated with PBA (eg, PD, AD, stroke, TBI, MS, or ALS).

• #101

  https://www.geron.org/News-Events/GSA-News/CEO-Blog/pseudobulbar-affect-an-often-overlooked-condition

  Understanding Pseudobulbar Affect, the inaugural publication of the new Insights Implications in Gerontology series from The Gerontological Society of America, addresses an often overlooked or misunderstood condition that has the potential to lead to decreased quality of life for older adults and their caregivers. […] PBA symptoms can cause embarrassment for older adults and their family and caregivers resulting in restricted social interactions, withdrawal, and social isolation. Thus, older adults with neurologic disorders and PBA experience additional burden of disease and reduced quality of life. […] Care providers (including family members and staff at long-term care facilities who observe patients laughing or crying inappropriately) may consider having the patient evaluated for PBA, especially if the patient has a neurologic condition or brain injury.

• #102 Identification of pseudobulbar affect symptoms in the nursing home setting: Development and assessment of a screening tool

  https://scholarlycommons.henryford.com/publichealthsciences_articles/435/

  Pseudobulbar Affect (PBA) is a neurologic condition characterized by involuntary outbursts of crying and/or laughing disproportionate to patient mood or social context. […] Although an estimated 9% of nursing home residents have symptoms suggestive of PBA, they are not routinely screened. […] Nursing home residents with PBA treated with dextromethorphan hydrobromide/quinidine sulfate (n = 140) were compared to age-, gender-, and dementia-diagnosis-matched controls without PBA or treatment (n = 140). […] Using a multivariable regression and best decision rule analysis, we found PBA in nursing home residents was associated with chart documentation of uncontrollable crying, presence of a neurologic disorder (e.g., Parkinson’s disease), or by the documented presence of at least 2 of the following: stroke, severe cognitive impairment, and schizophrenia. […] Based on these risk factors, an electronic screening tool was created.

• #103 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  PBA is often misdiagnosed as a psychiatric disorder, such as depression, or underrecognized in patients with conditions whose symptoms mimic those of PBA. […] Patients with PBA may have an appropriate response that is more intense, recurring, and hyperbolic. […] The symptoms can be severe, with persistent, incessant episodes having an abrupt unpredictable onset. […] Symptoms suggestive of PBA in nursing homes present in 17.5% of residents with neurological conditions and 9% of residents overall. […] Caregivers experience a substantial burden when caring for patients with PBA. […] Patients with PBA are aware of social norms and the inappropriateness of their responses. Thus, they are embarrassed by the inability to control these involuntary outbursts. […] Raising awareness of PBA through the education of healthcare professionals, patients, families, caregivers, and the public may result in increased recognition and better management of PBA.

• #104 Pseudobulbar Affect May Be An Early Marker Of Alzheimer’s Disease | VA Boston Health Care | Veterans Affairs

  https://www.va.gov/boston-health-care/news-releases/pseudobulbar-affect-may-be-an-early-marker-of-alzheimers-disease/

  Pseudobulbar affect, or PBA, is a neurological syndrome characterized by frequent, uncontrollable, mood incongruent episodes of laughing or crying that are unprovoked or disproportionate to the context. […] We hope that better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification and treatment, said co-author Dr. Brandon Frank, neuropsychologist at VA Boston Healthcare System and assistant professor of neurology at BU Chobanian Avedisian SOM. Medical education and training specific to PBA should be a priority for clinicians working with older adults, to help reduce the burden of advocacy currently placed on patients and their families.

• #105 Pseudobulbar Affect May Be An Early Marker Of Alzheimer’s Disease | VA Boston Health Care | Veterans Affairs

  https://www.va.gov/boston-health-care/news-releases/pseudobulbar-affect-may-be-an-early-marker-of-alzheimers-disease/

  Pseudobulbar affect, or PBA, is a neurological syndrome characterized by frequent, uncontrollable, mood incongruent episodes of laughing or crying that are unprovoked or disproportionate to the context. […] We hope that better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification and treatment, said co-author Dr. Brandon Frank, neuropsychologist at VA Boston Healthcare System and assistant professor of neurology at BU Chobanian Avedisian SOM. Medical education and training specific to PBA should be a priority for clinicians working with older adults, to help reduce the burden of advocacy currently placed on patients and their families.

• #106 Pseudobulbar Affect May Be An Early Marker Of Alzheimer’s Disease | VA Boston Health Care | Veterans Affairs

  https://www.va.gov/boston-health-care/news-releases/pseudobulbar-affect-may-be-an-early-marker-of-alzheimers-disease/

  Pseudobulbar affect, or PBA, is a neurological syndrome characterized by frequent, uncontrollable, mood incongruent episodes of laughing or crying that are unprovoked or disproportionate to the context. […] We hope that better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification and treatment, said co-author Dr. Brandon Frank, neuropsychologist at VA Boston Healthcare System and assistant professor of neurology at BU Chobanian Avedisian SOM. Medical education and training specific to PBA should be a priority for clinicians working with older adults, to help reduce the burden of advocacy currently placed on patients and their families.

• #107 Diagnosis and Treatment of Pseudobulbar Affect

  https://www.todaysgeriatricmedicine.com/archive/MA16p30.shtml

  This finding translated to a potential prevalence of PBA of 17.5% in the predisposed population (those with neurologic disorders and without psychosis or disruptive behavior) and 9% among all nursing home residents. […] The study also found that residents with PBA symptoms were more likely to be using antipsychotics, as well as anxiolytics and antidepressants. […] Identifying and managing PBA can be challenging for clinicians because it is underrecognized and the symptoms overlap with those of depression and other psychiatric disorders. […] Therefore, avoiding unnecessary medication use is recommended. This is particularly important in patients with PBA, where other treatment options are available. These findings underscore the importance of more accurate diagnosis of PBA.

• #108 Identifying Pseudobulbar Affect in Alzheimer’s Disease and Dementia – touchNEUROLOGY

  https://touchneurology.com/alzheimers-disease-dementia/journal-articles/identifying-pseudobulbar-affect-in-alzheimers-disease-and-dementia/

  Pseudobulbar affect (PBA) can be challenging to differentiate from the symptoms of various neurological diseases with which it is associated. […] PBA is common, affecting between 10-40% of people with AD but is frequently not detected or is misdiagnosed. […] Differentiating PBA from depression and other behavioral disturbances in AD and dementia is helpful to patients by identifying a specific cause of their symptoms and enabling appropriate management. […] A combination of dextromethorphan and quinidine has been shown in well-controlled trials and in clinical use to control the symptoms of PBA associated with several neurological diseases including AD and to reduce the burden on patients and their caregivers. […] After diagnosing PBA in the patient, explaining the condition to the patients and their caregivers is an important next step.

• #109 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) can be difficult to diagnose. Healthcare providers often misdiagnose it as a mood disorder especially depression or bipolar disorder. […] Theres no cure for pseudobulbar affect (PBA), but certain medications can help manage it. The goal of treatment is to reduce the frequency and severity of episodes of laughing or crying. […] Since pseudobulbar affect results from brain damage and neurological conditions, theres nothing you can do to prevent developing it. […] The prognosis (outlook) for PBA varies. […] Medication can help manage symptoms. It may be difficult to receive a diagnosis and treatment, but its important to continue to advocate for yourself. […] Laughing or crying uncontrollably can be challenging, embarrassing and difficult for other people to understand. Know that pseudobulbar affect (PBA) is a medical condition, and its manageable with medication. Talk to a healthcare provider if you develop signs of PBA. Theyre available to help you.

• #110 PBA Resources for Caregivers – PBA Voices

  https://pbavoices.org/resources/caregivers/

  Caring for a loved one with a neurological disorder, such as a stroke or traumatic brain injury, can be difficult. Watching your loved one struggle with pseudobulbar affect (PBA), particularly undiagnosed or untreated, compounds this difficulty. It is important to remember the PBA is not a psychiatric disorder. It is a secondary neurological condition resulting from a brain injury. You must be a champion when your loved one loses hope, isolates himself or herself, or appears depressed. […] Here are some tips for being a caregiver to a loved one with PBA: […] If you know someone with PBA, listen to his or her frustrations and concerns, and remind him or her that a physical condition (PBA) – not a mental one – is involved. […] Accompany your individual with PBA to doctor appointments, when possible. Share your observations about episodes, discuss treatment options, and process the doctor’s advice.

• #111 Pseudobulbar Affect (PBA): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17928-pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) can be difficult to diagnose. Healthcare providers often misdiagnose it as a mood disorder especially depression or bipolar disorder. […] Theres no cure for pseudobulbar affect (PBA), but certain medications can help manage it. The goal of treatment is to reduce the frequency and severity of episodes of laughing or crying. […] Since pseudobulbar affect results from brain damage and neurological conditions, theres nothing you can do to prevent developing it. […] The prognosis (outlook) for PBA varies. […] Medication can help manage symptoms. It may be difficult to receive a diagnosis and treatment, but its important to continue to advocate for yourself. […] Laughing or crying uncontrollably can be challenging, embarrassing and difficult for other people to understand. Know that pseudobulbar affect (PBA) is a medical condition, and its manageable with medication. Talk to a healthcare provider if you develop signs of PBA. Theyre available to help you.

• #112 Enhancing Approaches to the Identification and Management of Pseudobulbar Affect

  https://www.psychiatrist.com/jcp/enhancing-approaches-identification-management-pseudobulbar/

  The AAN guideline for managing psychiatric disorders in people with MS states that insufficient evidence is available to support or refute the use of antidepressants for PBA. The guideline states that the combination of dextromethorphan and quinidine may be considered. […] Increased recognition by health care professionals and the public may allow more affected individuals to be diagnosed and receive appropriate treatment. Patients with PBA and their families should be reassured that they are not alone. Treatment selection should be tailored for the individual, keeping in mind issues relating to safety and tolerability as well as the patients ability to adhere to treatment.

• #113 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  PBA is often misdiagnosed as a psychiatric disorder, such as depression, or underrecognized in patients with conditions whose symptoms mimic those of PBA. […] Patients with PBA may have an appropriate response that is more intense, recurring, and hyperbolic. […] The symptoms can be severe, with persistent, incessant episodes having an abrupt unpredictable onset. […] Symptoms suggestive of PBA in nursing homes present in 17.5% of residents with neurological conditions and 9% of residents overall. […] Caregivers experience a substantial burden when caring for patients with PBA. […] Patients with PBA are aware of social norms and the inappropriateness of their responses. Thus, they are embarrassed by the inability to control these involuntary outbursts. […] Raising awareness of PBA through the education of healthcare professionals, patients, families, caregivers, and the public may result in increased recognition and better management of PBA.

• #114 Pseudobulbar Affect in Parkinsonian Disorders: A Review

  https://www.e-jmd.org/journal/view.php?doi=10.14802/jmd.18051

  The pathophysiology of PBA is complex and incompletely understood. […] The suggested pathophysiology is also in accordance with the increased prevalence of PBA reported in atypical parkinsonian disorders, such as progressive supranuclear palsy (PSP) and the cerebellar type of multiple system atrophy (MSA-C). […] While numerous neurotransmitters are known to regulate signaling of this cortico-ponto-cerebellar circuitry, the exact role of these neurotransmitters and how they are disrupted in PBA has not been thoroughly elucidated to date. […] The treatment agents currently available for PBA are described below. […] Despite its relatively high prevalence in patients with neurological diseases, the recognition and diagnosis of PBA in the community remains subpar. […] The only support for the use of such medications in patients with parkinsonian disorders comes from case reports in PD patients with PBA secondary to STN-DBS or thalamotomy and in patients with MSA-C. […] PBA is a distressing neurological condition that is relatively common but underappreciated in the parkinsonian population. […] Greater attention to and exploration of PBA in patients with parkinsonian disorders is urgently needed.

• #115 Pseudobulbar Affect in Parkinsonian Disorders: A Review

  https://www.e-jmd.org/journal/view.php?doi=10.14802/jmd.18051

  The pathophysiology of PBA is complex and incompletely understood. […] The suggested pathophysiology is also in accordance with the increased prevalence of PBA reported in atypical parkinsonian disorders, such as progressive supranuclear palsy (PSP) and the cerebellar type of multiple system atrophy (MSA-C). […] While numerous neurotransmitters are known to regulate signaling of this cortico-ponto-cerebellar circuitry, the exact role of these neurotransmitters and how they are disrupted in PBA has not been thoroughly elucidated to date. […] The treatment agents currently available for PBA are described below. […] Despite its relatively high prevalence in patients with neurological diseases, the recognition and diagnosis of PBA in the community remains subpar. […] The only support for the use of such medications in patients with parkinsonian disorders comes from case reports in PD patients with PBA secondary to STN-DBS or thalamotomy and in patients with MSA-C. […] PBA is a distressing neurological condition that is relatively common but underappreciated in the parkinsonian population. […] Greater attention to and exploration of PBA in patients with parkinsonian disorders is urgently needed.

• #116 Pseudobulbar Affect in Patients with Multiple Sclerosis: A Systematic Review

  https://www.mdpi.com/2813-3064/2/3/13

  Therapeutic options for PBA have been examined in a limited number of studies, mainly focusing on patients with other neurological disorders. […] In a double-blind experimental study on dextromethorphan and quinidine therapy with an average observation period of 89 days, patients with MS and PBA reported reduced CNS-LS scores, frequency of symptoms, and pain intensity, as well as improved quality of life and social relationships, compared to the placebo group. […] Based on the results of our systematic literature review, it would be important for clinicians to pay particular attention to the differential diagnosis of emotional dysregulation in the context of MS, considering PBA alongside other affective disorders, and acknowledging potential overlaps in their clinical presentations.

• #117 Pseudobulbar Affect in Patients with Multiple Sclerosis: A Systematic Review

  https://www.mdpi.com/2813-3064/2/3/13

  Therapeutic options for PBA have been examined in a limited number of studies, mainly focusing on patients with other neurological disorders. […] In a double-blind experimental study on dextromethorphan and quinidine therapy with an average observation period of 89 days, patients with MS and PBA reported reduced CNS-LS scores, frequency of symptoms, and pain intensity, as well as improved quality of life and social relationships, compared to the placebo group. […] Based on the results of our systematic literature review, it would be important for clinicians to pay particular attention to the differential diagnosis of emotional dysregulation in the context of MS, considering PBA alongside other affective disorders, and acknowledging potential overlaps in their clinical presentations.

• #118 Pseudobulbar Affect in Patients with Multiple Sclerosis: A Systematic Review

  https://www.mdpi.com/2813-3064/2/3/13

  The differential diagnosis between PBA and other affective disorders, such as depression or mania, is often challenging. […] We set out to conduct a systematic literature review in order to determine the prevalence and clinical characteristics of PBA in patients with MS across the lifespan. […] The results of our systematic literature review provided an estimate prevalence figure for PBA in the context of MS ranging between 2% and 10%. […] The correlation between PBA and cognitive impairment of varying degrees indicate that cognitive deficits in MS could serve as both a risk factor for the development of PBA and a direct or indirect consequence of it. […] In general, PBA in the context of MS tends to increase patients’ overall disability, resulting in poorer quality of life, decreased autonomy, and distress for both patients and their caregivers.

• #119 Pseudobulbar Affect May Be An Early Marker Of Alzheimer’s Disease | VA Boston Health Care | Veterans Affairs

  https://www.va.gov/boston-health-care/news-releases/pseudobulbar-affect-may-be-an-early-marker-of-alzheimers-disease/

  Pseudobulbar affect, or PBA, is a neurological syndrome characterized by frequent, uncontrollable, mood incongruent episodes of laughing or crying that are unprovoked or disproportionate to the context. […] We hope that better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification and treatment, said co-author Dr. Brandon Frank, neuropsychologist at VA Boston Healthcare System and assistant professor of neurology at BU Chobanian Avedisian SOM. Medical education and training specific to PBA should be a priority for clinicians working with older adults, to help reduce the burden of advocacy currently placed on patients and their families.

• #120 Pseudobulbar Affect May Be An Early Marker Of Alzheimer’s Disease | VA Boston Health Care | Veterans Affairs

  https://www.va.gov/boston-health-care/news-releases/pseudobulbar-affect-may-be-an-early-marker-of-alzheimers-disease/

  Pseudobulbar affect, or PBA, is a neurological syndrome characterized by frequent, uncontrollable, mood incongruent episodes of laughing or crying that are unprovoked or disproportionate to the context. […] We hope that better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification and treatment, said co-author Dr. Brandon Frank, neuropsychologist at VA Boston Healthcare System and assistant professor of neurology at BU Chobanian Avedisian SOM. Medical education and training specific to PBA should be a priority for clinicians working with older adults, to help reduce the burden of advocacy currently placed on patients and their families.

• #121 When Tears Keep Falling: A Case Report of Pseudobulbar Affect

  https://www.psychiatrist.com/pcc/when-tears-keep-falling-case-report-pseudobulbar-affect/

  In stroke patients, PBA is a common disorder, affecting about 1 in 5 survivors in both acute and post-acute phases and 1 in 8 survivors beyond 6 months post-stroke. […] The likely pathophysiologic mechanism of PBA is the disruption of the cortico-ponto-cerebellar pathway. […] PBA is sometimes misinterpreted as a psychiatric disorder (depressive disorder, bipolar disorder, or posttraumatic stress disorder). […] The only approved pharmacologic treatment for PBA is dextromethorphan and quinidine (none are approved in Portugal for PBA treatment). […] Interdisciplinary work is fundamental in mental illnesses, and neuropsychiatric disorders are a representative paradigm of the necessity of a unified vision of mental disorders.

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