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Pseudobulbar Affect (PBA)

Topic Overview

What is PBA?

Pseudobulbar affect (PBA) is a problem in the brain that causes you to laugh or cry for no reason. When you have PBA, sudden fits of tears or laughter can come from nowhere. This behavior usually has nothing to do with what you're doing or feeling. And it's something you can't control. PBA tends to cause awkward social situations. It can make daily living very stressful.

PBA can happen along with certain health problems that affect the brain. Fortunately, there is medicine that can help improve PBA symptoms. Support from people who understand PBA can also help.

What causes PBA?

Brain damage from a stroke, brain tumor, or head trauma can lead to PBA. PBA can also happen along with such conditions as multiple sclerosis, Parkinson's disease, Alzheimer's disease, ALS and dementia.

Normally, the "feel" and "express" parts of your brain work together. But with PBA, the expressive part of your brain can trigger behavior on its own. Laughing or crying can happen at any time, no matter what you're feeling.

What are the symptoms?

When you have PBA, you may:

  • Suddenly cry or laugh for no reason. When your behavior is out of sync with people around you, it can be embarrassing or upsetting. And it can be stressful when your behavior upsets others.
  • Have trouble controlling how long or intensely you laugh or cry.
  • Feel none of the usual relief after crying or laughing.

How is PBA diagnosed?

Your doctor can diagnose PBA based on your symptoms and behavior, along with looking at your past health.

PBA is sometimes mistaken for depression or bipolar disorder.

How is it treated?

Medicine that affects certain brain chemicals usually improves PBA. Medicines include:

  • Antidepressant medicine, usually in a lower dose than for depression.
  • Dextromethorphan and quinidine (Nuedexta).

Support from people who understand PBA can also be helpful. Talk to people close to you about PBA. Be patient and kind to yourself, and ask for help if you need it.


Current as of: November 19, 2019

Author: Healthwise Staff
Medical Review: E. Gregory Thompson MD - Internal Medicine
Colin Chalk MD, CM, FRCPC - Neurology

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