Wednesday, March 21, 2018


A little piece that I was asked to write for Modern Day MS. A bit redundant, but here it is anyway.

Pseudobulbar Affect in Multiple Sclerosis

One of the strangest symptoms associated with MS—a disease which is typified by strange symptoms to begin with—is a symptom known as Pseudobulbar Affect (PBA).

PBA is a condition involving sudden, excessive laughter or crying in the absence of any particular trigger. Normally, the cerebral cortex (at the front of the brain) communicates with the cerebellum (at the back of the brain) to control emotional responses to situations. However, the cerebellum can become damaged by MS lesions or nerve problems, disrupting communications between these two areas.

Now, I don’t know if I actually have diagnostic Pseudobulbar Affect. What I do know is that over the last year or so I have experienced unusual, unaccountable episodes of both irrepressible hilarity or tearful despondency  without any sufficient cause.

As an example, recently I was writing something in my blog and wanted to use the word “dignification”. I then began to wonder, however, whether this is actually a word, so I typed the word into Google. Upon hitting enter, I noted that I had typed “dog”nification. This is what got me started. I next noted, looking at the screen, that “dognification” is an actual word—and from there, it was off to the races. I laughed helplessly, completely unable to stop myself, tears rolling down my cheeks, face red, ribs sore, for more than half an hour—wondering all the while why I was laughing, because the thing really was not that darn funny.

Similarly, I awoke one recent morning feeling vaguely sad—perhaps under the influence of some waning memory of a dream. I went about my usual practice of making a cup of coffee and sitting down to drink it at the table in the back yard, and then suddenly I began to weep, tears freely flowing from my eyes, shoulders shaking, nose running—all without any particular reason.

Generally, I have never been the sort of person who easily cries, or laughs either, for that matter—a stoicism passed on, no doubt, by my father. And yet now I find myself, without warning, suddenly in the midst of these outbursts of laughter or tears flowing as if from an open tap! Strange.

On the other hand, although PBA is one of the stranger symptoms in MS, it is also one of the more pleasant ones, certainly preferable to physical pain. There is a certain release to be had in both laughter and weeping, an engagement in emotion that leaves one strangely satisfied when he’s gotten it all out of his system, so to speak.

If, however, the symptom has become especially extreme, or embarrassing, there are apparently some measures one can take—the use of SSRI’s, such as Zoloft, for instance. If need be, ask your neurologist.

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