Bahubali star Anushka Shetty recently spoke about her neurological condition of uncontrollable bouts of laughter or tears. Pseudobulbar Affect is the condition where a person is not in control of their laughter or their tears, and usually ends up having bouts of them in inappropriate situations. Remember Arthur Fleck in the 2019 movie Joker – the titular character who couldn’t control laughter? He suffered from the same condition of Pseudobulbar Affect.

In an interview with HT Lifestyle, Dr Prashant Makhija, Neurologist, Wockhardt Hospitals, Mumbai Central, said, “Pseudobulbar Affect (PBA) is a neurological condition characterized by sudden, uncontrollable episodes of laughter or crying that are disproportionate or inappropriate to the situation. It occurs due to disruptions in the pathways between the brain's higher centers and the bulbar muscles, which control facial expressions, speech, and swallowing.”

Pseudobulbar Affect: Causes

Often neurological disorders affect parts of the brain responsible for emotional regulation – this can lead to Pseudobulbar Affect. Some of the causes are stroke, Amyotrophic Lateral Sclerosis, Multiple sclerosis, Traumatic brain injury, Alzheimer's disease, Parkinson's disease and brain tumours.

Pseudobulbar Affect: Symptoms

Sudden, uncontrollable laughter or crying: These episodes can be triggered by seemingly unrelated events or even occur spontaneously.

Mismatch of emotional expression: The emotional response does not correspond to the person’s actual feelings

Frequency and duration: These episodes can vary in frequency and can last from a few seconds to several minutes.

Pseudobulbar Affect: Treatment

“Although there is no cure for PBA, several treatment options can help manage symptoms,” said Dr. Vivek Barun, Consultant - Neurology & Epilepsy, Department of Neurology, Artemis Agrim institute of Neuroscience.

Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) can help in modulating emotional responses.

Nuedexta: A combination of dextromethorphan and quinidine, especially approved for treating PBA, helps in reducing the frequency and severity of episodes.

Behavioral therapy: This can help individuals in developing coping strategies and reduce the impact of PBA on their daily lives.

Support groups: They provide a platform for individuals to share experiences and coping mechanisms.

Patient and caregiver education: Understanding PBA can help in managing expectations and improve communication.

Social support: Encouragement from family and friends can help in mitigating the social and emotional impact of PBA.

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