Embarrassing, Uncontrollable, But Common: A Side Effect From Stroke That Leaves You Laughing Or Crying

Mention stroke and you might think of physical side effects like paralysis or muscle weakness. Or there are cognitive issues that make it difficult to speak. There are other side effects—cognitive in particular—that are possible, too.

A common cognitive post-stroke side effect is called pseudobulbar affect, or PBA for short. It’s a brain disorder that causes uncontrollable crying or laughing. These unintended emotional outbursts can be extremely embarrassing for everyone involved. Here’s what you should know.

Totally Unintentional

Often people who observe stroke victims with PBA think that there’s some exaggeration going on. The responses seem inappropriate. One thing’s for sure: the response does not represent this person’s true feelings.

Unfortunately, someone with PBA might cry when hearing good news. Or they may suddenly burst into a sobbing fit while they are laughing. Something only mildly sad can cause them to become hysterical.

Even more alarming, someone with PBA can have these spontaneous emotional outbursts without any trigger at all. And perhaps most troubling of all is that these episodes can happen up to 100 or so times daily.

Not Well Known

The unpredictable nature of PBA can be embarrassing for those who have the condition, as well as those who care for them. Many older adults experiencing PBA simply become unwilling to be around other people.

Although more than half of all stroke survivors report having PBA symptoms, less than 20% of them know the cause. In most cases, they’ve never even heard of the condition. Life for them becomes frustrating and sometimes devastating because they have no idea why this behavior is happening to them.

What Causes BPA?

The condition occurs when a stroke damages areas of the brain controlling how emotion is expressed. The damage short circuits brain signals, causing involuntary episodes of laughing or crying. And, since it’s a short signal, the laughing or crying is usually highly exaggerated.

Although stroke is the likely cause of PBA, it’s also a side effect caused by other neurological disorders—including dementia, and Parkinson’s disease.

PBA causes uncontrollable crying, so it’s often mistaken for depression—and this is a condition that many seniors experience. As a result, PBA might be misdiagnosed. Both PBA and depression are conditions that can last for extended periods of time, so it’s important to make sure a correct diagnosis is determined.

There are specific medications to treat PBA, but a medical professional also may prescribe an anti-depressant. Both can help to suppress the involuntary emotional outbursts, but it may not be possible to stop them completely.

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