Sudden outbursts of crying or laughing can be a sign of fine acting. But for some, it could be PBA.

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Sudden outbursts of crying or laughing can be a sign of fine acting. But for some, it could be PBA. Danny Glover PseudoBulbar Affect (PBA) affects people with certain neurologic conditions or brain injuries.

Who gets PBA? For me, as an actor, crying or laughing is a matter of choice. But if you have a brain injury or certain neurologic condition, your crying or laughing may be uncontrollable. It s caused by a neurologic condition called PBA, PseudoBulbar Affect. Though you may have never heard of PBA, you re not alone. Nearly two million Americans with certain neurologic conditions or brain injuries are estimated to suffer from it. PBA doesn t discriminate. It can affect men and women, old and young. Conditions or injuries that can lead to PBA include: Alzheimer s disease or other dementias Stroke Traumatic brain injury (TBI) Multiple sclerosis (MS) Parkinson s disease Lou Gehrig s disease (ALS) This booklet is a great place to start learning about PBA. The next step is to talk to your doctor. Because PBA is treatable. Danny Glover TEXT PBA to 313131 for a video message from Danny Glover. Message and data rates may apply. 2 3

PBA is neurologic 9 Essential Questions One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down to the brainstem which in turn sends signals to the face and other parts of the body that show emotion. PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion. The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. Ask Yourself 1. Do I have a neurologic condition or brain injury, and can I describe my uncontrollable crying or laughing episodes in any of the following ways? sudden or unexpected exaggerated (more intense or last longer than the situation calls for) inappropriate or do not match what I am feeling inside 2. Have I avoided spending time with family or friends because of my unpredictable outbursts of crying or laughing? 3. Have I let my doctor know I am experiencing these symptoms and that they are bothering me? 4. Could my crying episodes be mistaken for depression? Motor cortex Frontal and temporal cortex Network disrupted Brainstem Bulb Cerebellum Involuntary laughing/crying Ask Your Doctor 5. Do you think I have the neurologic condition called PBA? 6. Is PBA treatable? 7. Are there any treatment options that can help me manage my PBA episodes? 8. How long might I need to be treated for my PBA? 9. What do I need to consider when making changes to my current treatment plan? 4 5

Get your free PBA Facts kit PBA FACTS All About P seudob ulbara ffect Some of the PBA patients you ll meet Henry s story I was so embarrassed by my crying, I didn t want to go out in public. Luckily, my wife discovered the term PBA online. Henry The Center for Neurologic Study-Lability Scale (CNS-LS) Using the scale below, please write the number that describes the degree to which each item applies to you DURING THE PAST WEEK. Write only 1 number for each item. never rarely occasionally frequently most of the time 1 2 3 4 5 To learn more about this treatable neurologic condition, sign up for your free PBA Facts kit. The kit includes: The science of PBA The differences between PBA and depression Stories from PBA patients and their caregivers Access to the PBA Facts website featuring 6 videos with neurologist, Dr. S. Azhar, and psychiatrist, Dr. P. Zafirides Henry had a stroke in 2001 See Henry s complete story at pbafacts.com. Sheila and Dominique At first I thought my mom was just depressed. Her doctor thought different. Dominique Assessment Questions 1 2 There are times when I feel fine one minute, and then I ll become tearful the next over something small or for no reason at all. Others have told me that I seem to become amused very easily or that I seem to become amused about things that really aren t funny. 3 I find myself crying very easily. 4 5 6 I find that even when I try to control my laughter, I am often unable to do so. There are times when I won t be thinking of anything happy or funny at all, but then I ll suddenly be overcome by funny or happy thoughts. I find that even when I try to control my crying, I am often unable to do so. 7 I find that I am easily overcome by laughter. Answers To sign up for your free kit, visit pbafacts.com today or call 1-800-992-5240. Sheila has early Alzheimer s disease. Her daughter, Dominique, cares for her. See Sheila s complete story at pbafacts.com TOTAL SCORE The PBA Assessment tool has been validated in ALS and MS patient populations. Please share the results with your doctor. 6 7 8

Do you have PBA? The PBA assessment tool was developed by healthcare professionals and is called the Center for Neurologic Study Lability Scale (CNS-LS). Simply answer the 7 questions and add up your score. If it s 13 or higher, that may suggest you are having PBA symptoms and should discuss with your doctor. This assessment tool is not intended to substitute for professional medical assessment and/or advice. Uncontrollable crying or laughing is difficult for the patient and family to manage. Diagnosing PBA gives them hope and a sense of relief. Take the assessment Fill out this PBA assessment and take it to your doctor. Name: Date of assessment: Underlying Neurologic Condition: Alzheimer s Disease Multiple Sclerosis (MS) or Dementia Parkinson s Disease Stroke Lou Gehrig s Disease (ALS) Traumatic Brain Injury (TBI) Other Neurologic Condition S. Azhar M.D., Neurologist Chairman, Department of Neurology and Rehabilitation Lutheran Medical Center, NY Ask your doctor about PBA. To learn more, call 1-800-992-5240 or go to pbafacts.com. 9 2015 Avanir Pharmaceuticals, Inc. All Rights Reserved. PBA-0175-BRO-0415