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Saturday, October 27, 2007

Emotional Lability AKA Pseudobulbar Affect

ferncohen.com
EMOTIONAL LABILITY aka “pseudobulbar affect” is actually a neurological symptom of ALS. It is uncontrollable fits of crying or laughing. Sometimes the laughing comes after the crying or vice-versa. Or sometimes there is just laughing, or just crying. It can be embarrassing, because sometimes it is inappropriate. But once it starts, it is so difficult to stop. It can be scary too, because it is something you have no control over.

When I get on a crying jag, I sob really loudly and then my breathing suffers. Prolonged laughing is healthier, but it affects my breathing if I can’t stop.

There is medicine, which helps. Mine is a liquid compound of quinidine and dextromethorphan, which is found in most over-the-counter cough medicines. My neurologist says that nobody knows why or how it works. This statement puzzles me because I don’t know how they discover a drug if they don’t know why or how it works. Oh well; however they found it, I’m glad it’s around.

Michael Zaslow, the soap-opera actor who died a few years ago of ALS describes this symptom at length in his book “Not That Man Anymore”. He talks of long and embarrassing episodes of crying, and of laughing in inappropriate situations. It had to be so puzzling to everybody around him to see a man blubbering for no apparent reason, especially since he was out in public so much. There is a very good discussion of emotional lability in Wikipedia at http://en.wikipedia.org/wiki/Emotional_lability
“While not as profoundly disabling as the physical symptoms of these diseases, labile affect can have a significant impact on individuals' social functioning and their relationships with others. In a disease such as Motor Neuron Disease, the majority of patients are cognitively normal; however, the appearance of uncontrollable emotions is commonly associated with learning disabilities. This may lead to severe embarrassment and avoidance of social interactions for the patient, which in turn has an impact on their coping mechanisms and their careers.”

Anyway, just another thing we people with ALS deal with.
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