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Pseudobulbar Affect

 


BASICS

  • Pseudobulbar affect (PBA) is a neuropsychiatric disorder consisting of brief emotional outbursts thought to be caused by disruption of corticobulbar or cortico-subcortical-thalamo-cerebellar ci...

DIAGNOSIS

No formal set of diagnostic criteria exists in either the DSM or the ICD system. The following include recently proposed criteria for the diagnosis of PBA. 

HISTORY

  • Careful history is crucial ...

TREATMENT

MEDICATION

The combination of dextromethorphan (N-methyl-d-aspartate [NMDA] blocker)/quinidine (inhibits dextromethorphan metabolism) has not been tested in comparison with antidepressant age...

ADDITIONAL READING

  • Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, st...

CODES

ICD10

F48.2 Pseudobulbar affect 

ICD9

310.81 Pseudobulbar affect 

SNOMED

432776007 pseudobulbar affect (finding) 

CLINICAL PEARLS

  • The key feature of PBA is the dissociation from the experience (internal/mood) and the emotional expression (external manifestation/affect).

  • PBA is an often underdiagnosed or misdiagnos...

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