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Kevin Duffan
Kevin Duffan
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Little-Known Complication of Brain Injury Leads to Uncontrollable Crying and Laughing

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Awareness of long-term concussion complications has grown exponentially over the past five years. The discovery of the Alzheimer’s disease-like degenerative neurological condition known as chronic traumatic encephalopathy, or CTE, among NFL players who sustained multiple concussions during their careers resulted in significant changes in how football is played and officiated at all levels. Additionally, class-action lawsuits involving professional and college football players who believe their health was put at risk unnecessarily have reached settlement stages.

Now, Barry Sanders, one of the most talented running backs the game has ever seen, is working to focus researchers, health care providers and victims of traumatic brain injuries on a potential complication of TBIs called pseudobulbar affect.

An estimated 2 million Americans suffer from PBA, the symptoms of which include uncontrollable outbursts of crying or laughing. Patients generally do not feel the emotions their bodies exhibit so strongly, and the unexpected nature of the outbursts often lead sufferers to withdraw from their friends and families. Cases of PBA have been described in individuals with various forms of dementia, victims of car accidents and falls, and athletes such as boxers and football players whose professions necessitated taking repeated blows to the head.

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Lesions in the area of the brain that regulate emotions appear to cause pseudobulbar affect, which is more commonly called PBA.

PBA often gets mistaken as a manifestation of depression by doctors and patients. Misdiagnosing the condition as a mood disorder, however, results in ineffective treatment. A recently discovered combination of the cough medication dextromethorphan and quinidine, which treats both malaria and irregular heartbeats, shows promise for controlling PBA symptoms, but correctly identifying the problem is essential.

Not every person who sustains a bad concussion or other TBI will develop PBA, of course. But for those who do, the impact on their lives can be severe. As explained in Psychology Today,

The side-effects for PBA sufferers include feelings of emotional exhaustion and, frequently, social isolation. Without realizing that they have a medical problem, people with PBA often adapt their lives to avoid things that trigger the response, including interacting with others unless they absolutely have to. With social isolation comes more negative emotion that can over time manifest as depression.

TBIs can create lifelong disabilities. Learning more about PBA as one of the possible consequences of such head and brain injuries, as well as how to treat it, can only help. To find out more about recognizing and controlling the condition, visit Tackle PBA.

EJL