Pseudobulbar affect (pathological laughing and crying)
Some people with multiple sclerosis find that they experience sudden episodes of uncontrollable laughing and/or crying at inappropriate times, or which are unrelated, or out of proportion, to their current mood.
This can happen if MS lesions have occurred in the areas of the brain that control your emotions. These excessive emotional symptoms are known by a number of names including:
- pseudobulbar affect
- pathological laughing and crying
- emotional lability
- emotional incontinence
- emotionalism.
Pseudobulbar affect (PBA) is seen in many other conditions including motor neurone disease (MND), Alzheimer's disease, Parkinson's disease, stroke and traumatic brain injury.
Find out more
- MS and your feelings
- Symptoms of MS
- NICE MS guideline Read the section on emotional lability
References
- Advances in Therapy 2011; 28(7):586-601. Summary Pseudobulbar affect: an under-recognized and under-treated neurological disorder.
- Annals of Neurology 2006;59(5):780-787. Summary Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.
- New York, NY: National Multiple Sclerosis Society; 2012. Full text A Clinical Bulletin from the Professional Resource Center of the National Multiple Sclerosis Society: Pseudobulbar affect (uncontrollable laughing and/or crying).
- Therapeutics and Clinical Risk Management 2013;9:483-489. Full text Pseudobulbar affect: prevalence and management.
- Acta Clinica Croatica 2015;54(2):159-163. Summary Pseudobulbar affect in multiple sclerosis patients.
- Journal of Clinical Psychiatry 2016;77(9):e115. Summary Enhancing approaches to the identification and management of pseudobulbar affect.
- London: EMA; 2016. Full text Nuedexta: withdrawal of the marketing authorisation in the European Union.
- Northampton: MNDA; 2016. Full text Withdrawal of marketing authorisation for Nuedexta.



Inappropriate laughing or crying?
4 September 2013
This research update looks at how common the pseudobulbar affect (laughing or crying for little reason or at inappropriate times) is in MS.