Work et al. Adv Ther. 2011 Jun 6. [Epub ahead of print]
Some of you may recognise a "pseudobulbar affect"; it is a syndrome of emotion that comprises disinhibition, characterised by uncontrollable, exaggerated, and often inappropriate emotional outbursts, which may cause severe distress, embarrassment, and social dysfunction. MS is a common cause of a pseudobulbar affect and typically occurs in patients with progressive disease that are disabled. The presence of pseudobulbar affect occurs when MS lesions involve the frontal lobes or the pons in the brain stem (see figure below). In this large online survey ~10% of subjects had pseudobulbar affect; this high figure indicates that the condition is under-recognised. This is important as there are effective treatments that can reduce the frequency and intensity of these emotional outbursts. If this affects you and has not been recognised, you may want to bring it to the attention of your medical team.