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Recognizing and treating pseudobulbar affect

Published online by Cambridge University Press:  03 January 2017

William M. Sauvé*
TMS NeuroHealth Centers of Richmond and Charlottesville, Glen Allen and Charlottesville, Virginia, USA
*Address for correspondence: William Sauvé, MD, Greenbrook TMS Neurohealth Centers, 100 Eastshore Dr., Glen Allen, VA 23059, USA. (Email:


Pseudobulbar affect, thought by many to be a relatively newly described condition, is in fact a very old one, described as early as the 19th century. It refers to those who experience inappropriate affect, disconnected from internal state, or mood, generally thought to be the result of an upper motor neuron injury or illness. One possible explanation for this condition’s relative obscurity is the dearth of treatment options; clinical medicine is not typically in the habit of identifying conditions that cannot be modified. Now, however, there is good evidence for the treatment of pseudobulbar affect, and even a therapy approved for use by the U.S. Food and Drug Administration (FDA). As a result, appropriate identification and subsequent management of pseudobulbar affect is more important than ever. This article purports to summarize the origins of pseudobulbar affect, most current hypotheses as to its physiopathology, clinical identification, and evidence for management.

CME Review Article
© Cambridge University Press 2016 

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This activity is supported by an unrestricted educational grant from Avanir Pharmaceuticals.


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