Topic Info
Pseudobulbar affect (PBA), emotional lability, labile affect or emotional incontinence refers to a neurologic disorder characterized by involuntary crying or uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs secondary to neurologic disease or brain injury. Patients may find themselves crying uncontrollably at something that is only moderately sad, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient might laugh uncontrollably when angry or frustrated, for example.
Guest Info
David Diehl is a 54 year old farmer, hand-cyclist and paraplegic. Diagnosed with MS in 1991, he lost the use of his legs one year after his diagnosis. In 1998, David started to experience cognitive impairment. It was during this time that his neurologist, Dr. Dennis Dietrich, asked him if he ever experienced any uncontrollable laughing or crying. Not realizing this could be a separate medical condition, he answered, “yes” and was relieved to know he wasn’t losing his mental faculties as well as his legs.
Losing the use of his legs as well as the sight in his left eye as result of his MS, David is no stranger to overcoming obstacles; however, he said the public perception of his inappropriate laughing is worse for him than being in a wheelchair. He also lost his brother to ALS whom he noted likely suffered from PBA as well, a few years ago. David definitely found relief on the treatment he was given for his PBA during the trial and would be eager to resume therapy if there was one available.
David and his family, wife of 35 years, three children, their spouses and three grandchildren—soon to be four in a few weeks—are all active in their local church. Despite his many setbacks, he still continues to hand-cycle nearly 1000 miles a year, though he admits it’s getting tougher.
With the help of his brother and son, he tends to his farm of 7000 acres and 270 cattle. He said he refuses to become a prisoner of his diseases. Of his PBA he stated that he would like to help educate folks that, “I’m not some crazy person in a wheelchair laughing at the funeral. It’s a disease,” and is eager to participate in activities for the education and treatment of PBA.
