I have experienced a couple of episodes whereby I laugh at the most inappropriate of times. This doesn’t seem to really reflect my mood either. I wondered if this was a symptom of my MS?

This is very likely a symptom of MS and is known as the pseudobulbar affect (PBA). It’s otherwise known as emotional lability, or emotional disinhibition.

It can present itself as episodes of uncontrollable, exaggerated, laughing and/or crying or even episodes of anger. It usually happens suddenly and often at inappropriate times. PBA can happen without any kind of emotional trigger and is often associated with cognitive impairment and mood problems.

It is thought to be caused by a lesion affecting a specific part of the brain that controls emotions – the frontal lobe. Nerve pathways are disrupted from other parts of the brain to the cerebellum, which is the part of the brain that ensures emotional responses are appropriate.

A person’s outward responses may not match how they feel inside. This can be misinterpreted by others around them, and their real emotions can be misunderstood.

A small study suggests that it is likely more common in women living with secondary progressive MS. It appears that many people do not discuss this symptom with their MS team, suggesting that more awareness is needed.

The symptoms of PBA respond to tricyclic and SSRI antidepressants. More commonly prescribed are citalopram or sertraline.

Do you have a question about MS, or just want to talk? We are here for information and emotional support. Call 0800 783 0518 weekdays 10am-4pm.