Understanding PLC, a neurological disorder where patients experience episodes of uncontrollable laughter or crying or both

Pathological laughter and crying (PLC) is a neurological disorder in which the patient loses control over the part of the brain that emotes.

Myupchar August 27, 2019 13:42:51 IST
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Understanding PLC, a neurological disorder where patients experience episodes of uncontrollable laughter or crying or both
  • Pathological laughter and crying (PLC) is a neurological disorder in which the patient loses control over the part of the brain that emotes

  • A disturbance in the frontal lobe of the brain, in some cases, can lead to loss of control over laughter and crying

  • According to the US Food & Drug Administration, patients diagnosed with PLC should be given Nuedexta as the first-line medication

Pathological laughter and crying (PLC), also known as pseudobulbar affect, is a neurological disorder in which the patient loses control over the part of the brain that emotes. Patients can experience episodes of uncontrollable laughter or crying or both. This can happen with or without triggers.

In fact, Joaquin Phoenix, a well-known method actor, told an Italian publication, Il Venerdi, that he studies people suffering from pathological laughter for his role in the movie Joker - based on the famous villain from Gotham City in the DC Universe.

Understanding PLC a neurological disorder where patients experience episodes of uncontrollable laughter or crying or both

Representative image. Image source: Pixabay

Understanding pathological laughter

The frontal lobe of the brain controls one's emotional displays. A disturbance in this part of the brain can, in some cases, can lead to loss of control over laughter and crying.

As to why and how exactly this happens, scientists have been trying to puzzle it out since 1886. In 1924, a researcher named Kinnier Wilson put forward the theory that lesions in the brain that “disinhibit” the centres which control voluntary laughter and crying might be responsible. A few years ago, doctors at the U.S.-based Mayo Clinic debunked even this theory.

“If the inhibitory pathways are damaged in these patients, why do they not laugh or cry constantly, or why do they sometimes exhibit a response contradictory to the emotional valence of the triggering stimulus?” wrote Dr Josef Parvizi et al. in the November 2006 issue of Mayo Clinic Proceedings.

Other neurological disorders

According to American Stroke Association, the pseudobulbar disorder can also be initiated due to multiple other diseases including amyotrophic lateral sclerosis (ALS), Parkinson’s, traumatic brain injury, multiple sclerosis, dementia, and brain tumours.

Due to these disorders, there is a disconnection between the frontal lobe and the cerebellum and brainstem. This leads to a loss of control over reflexes and may lead to a sudden blast of emotions.

In April 2007, Anju Gupta, Kedar M. Aggarwal, Rajesh K. Rastogi of the Department of Psychiatry, Safdarjung Hospital and VMMC, wrote in the Delhi Psychiatry Journal that they too had found overlaps between the existence of pathological laughter and other neurological conditions like multiple sclerosis, Alzheimer’s disease, cerebrovascular disease, traumatic brain injury or brain tumours in patients.

The social cut-off

Embarrassing as it may be to laugh at the wrong time, what's worse is that patients with PLC often face social isolation. Early diagnosis and treatment can help patients lead a happier life.

According to the US Food & Drug Administration, patients diagnosed with PLC should be given Nuedexta as the first-line medication. Of course, medical practitioners are in the best position to advise proper treatment, based on the patient’s medical history, age, and other factors.

Other ways to manage the disease involve a little bit of patience, the right medication and a lot of trust. Talking about mental health issues in the home, at school and in general may also encourage people who need help to come forward.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. To know about brain tumours, please visit https://www.myupchar.com/en/disease/brain-tumour

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