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Pseudobulbar affect after stroke: a narrative review.

Tarun Girotra1, Forrest Lowe1, Wuwei Feng1

  • 1a Department of Neurology , Medical University of South Carolina , Charleston , SC , USA.

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|September 15, 2018
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Summary
This summary is machine-generated.

Pseudobulbar affect (PBA) is an under-recognized condition in stroke survivors, causing emotional dysregulation. Early diagnosis and treatment of PBA are crucial to reduce its significant psychosocial burden.

Keywords:
Strokeclinical presentationemotion incontinenceepidemiologypathophysiologypseudobulbar affecttreatment

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Pseudobulbar affect (PBA) is a neuropsychological condition characterized by emotional lability and affective dysregulation.
  • It is associated with various neurological conditions, including stroke, traumatic brain injury, and neurodegenerative diseases.
  • PBA is often misdiagnosed as post-stroke mood disorders, leading to under-recognition and under-treatment.

Purpose of the Study:

  • To conduct a comprehensive narrative synthesis of the existing literature on pseudobulbar affect (PBA).
  • To elucidate the epidemiology, pathophysiology, clinical features, and diagnostic challenges of PBA in stroke survivors.
  • To review the public health impact and available therapeutic options for PBA.

Main Methods:

  • A literature review was conducted using PubMed.
  • Search terms included "pseudobulbar atrophy," "emotional incontinence," and "stroke."
  • Manuscripts in English were appraised, and relevant content was extracted, synthesized, and summarized.

Main Results:

  • A narrative overview covered the epidemiology, pathophysiology, and clinical features of PBA.
  • Differential diagnosis, public health impact, and therapeutic strategies were also discussed.
  • PBA presents a significant psychosocial burden on stroke survivors and their families.

Conclusions:

  • Pseudobulbar affect (PBA) remains an under-treated condition with a substantial psychosocial impact.
  • Consensus-based diagnostic criteria for PBA have advanced, emphasizing early identification and prompt treatment.
  • Further research is needed for improved diagnostic criteria and cost-effective therapies for PBA.