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  • #4495
    Joyce Hoffman

    Is PBA (pseudobulbar affect) where one cries and laughs at inappropriate times common with stroke?

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    • Strokefocus Admin

      Robyn, does a person have to stay with this drug or after taking it for a while it will cure  PBA?

    • Anonymous

      Fortunately for me, my PM&R physician recognized my symptoms as PBA.  He prescribed Nuedexta, and the results were very fast and almost miraculous.  I stopped laughing right away and the crying eased a couple weeks later.  Unfortunately, this drug is terribly expensive and private insurance copays may be prohibitive to many survivors, especially those with financial worries already.  But PBA is real and is an unsettling new diagnosis for survivors to deal with.  Nuedexta offers a real  answer to symptoms, if you can afford it.  I’ve been able, with my doctor’s ok, to halve my dose over time, saving me some money.

    • Strokefocus Admin

      This is from the Mayo Clinic. Thanks for starting this topic:


      Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

      If you have pseudobulbar affect you’ll experience emotions normally, but you’ll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.

      Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.


      The primary sign of pseudobulbar affect (PBA) is frequent, involuntary and uncontrollable outbursts of crying or laughing that are exaggerated or not connected to your emotional state. Laughter often turns to tears. Your mood will appear normal between episodes, which can occur at any time. Crying appears to be a more common sign of PBA than laughing.

      The degree of the emotional response caused by PBA is often striking, with crying or laughing lasting up to several minutes. For example, you might laugh uncontrollably in response to a mildly amusing comment. Or you might laugh or cry in situations that others don’t see as funny or sad. These emotional responses typically represent a change from how you would have previously responded.

      Because pseudobulbar affect often involves crying, the condition is frequently mistaken for depression. However, PBA episodes tend to be short in duration, while depression causes a persistent feeling of sadness. Also, people with PBA often lack certain features of depression, such as sleep disturbances or a loss of appetite. But depression is common among those who have pseudobulbar affect.

      When to see a doctor

      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. Helpful specialists include neuropsychologists, neurologists and psychiatrists.

      It’s suspected that many cases of pseudobulbar affect go unreported and undiagnosed due to a lack of awareness about the condition.

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