Pseudobulbar Palsy
PBA, or pseudobulbar affect, is a neurological condition marked by uncontrollable and involuntary emotional outbursts like unexpected and inappropriate sobbing or laughing. These episodes may not be connected to the person’s emotional state and may occur in reaction to positive and negative stimuli. (1) Episodes of inappropriate and exaggerated emotional reactions inconsistent with true feelings can occur in people with pseudobulbar palsy. Uncontrollable periods of crying, laughing, or both may occur during these episodes, frequently in reaction to little triggers. The emotional outbursts can come on suddenly, be quite strong, and have little to do with the person’s underlying emotional condition or the situation’s context. (2)
Although the exact cause of pseudobulbar palsy is unknown, it is believed that disruptions in the brain networks that control emotional expression are to blame. The cerebral cortex, brainstem, and associated circuits are the brain areas liable for these changes due to injuries or lesions.
Treatment
The main goals of treatment for pseudobulbar palsy are to reduce symptoms and enhance the quality of life for those affected. Consider the following treatment possibilities: (3)
• Occupational therapy: Occupational therapy aims to increase a person’s capacity to carry out everyday tasks and preserve independence. Occupational therapists can offer solutions and adjustments for overcoming difficulties with coordination, fine motor skills, and daily living activities.
• Speech treatment: For people with pseudobulbar palsy who have trouble speaking and swallowing, speech and language therapy may be helpful. Speech therapists can offer techniques and exercises to help with swallowing and speech clarity.
•Physical treatment: People with pseudobulbar palsy may benefit from physical therapy, particularly if they struggle with movement, muscle weakness, or decreased balance. Strength, coordination, and general physical functioning can all be enhanced by using personalised exercise programmes created by physical therapists.
• Helpful care: People with pseudobulbar palsy require an understanding and helpful atmosphere. By educating people about the condition, family, friends, and carers can better support the patient and lessen stigma.
⚫ Treatment for underlying illnesses: Multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) are two neurological conditions that frequently coexist with pseudobulbar palsy. The symptoms of pseudobulbar palsy can also be reduced by treating and controlling these underlying diseases. It may entail using disease-modifying drugs, physical therapy, symptom-management techniques, and continued supervision by a neurologist or other qualified professionals.
It’s critical to stress that a person’s circumstances, the underlying cause, and the intensity of their symptoms may all affect how effective these therapy alternatives are. The most effective way to address the distinct requirements and difficulties presented by those with pseudobulbar palsy is frequently through a thorough and individualized strategy, including a multidisciplinary team of healthcare specialists.
A healthcare professional, such as a neurologist or a rehabilitation medicine specialist, should be consulted for an accurate diagnosis and to review the best treatment options depending on each patient’s unique needs.
References
Long, L., Cai, X. D., Wei, X. B., Liao, J. C., Xu, Y. Q., Gao, H. M., … & Wang, Q. (2015). Progressive supranuclear palsy: what do we know about it? Current Medicinal Chemistry, 22(10), 1182- 1193.
https://www.ingentaconnect.com/content/ben/cmc/2015/00000022/00000010/art00004
Saleem, F., & Munakomi, S. (2020). Pseudobulbar Palsy. https://europepmc.org/article/nbk/nbk553160
Balakrishnan, P., & Rosen, H. (2008). The causes and treatment of pseudobulbar affect in ischemic stroke. Current Treatment Options in Cardiovascular Medicine, 10(3), 216-222. https://link.springer.com/article/10.1007/s11936-008-0023-z.