9. Emotional Incontinence
Also known as the Pseudobulbar affect, emotional incontinence refers to a loss of the cortical control of emotions that is characterized by episodes of disproportionate and uncontrollable crying or laughing. Often, these episodes are mood incongruent, meaning patients will laugh during sad situations and vice versa.
Emotional incontinence outbursts typically occur several times a day with each episode lasting several minutes at a time. This symptom, while not necessarily clinically significant, does generate a great deal of social anxiety in most patients because it can adversely influence their ability to relate to others. It is important to emphasize that ALS patients retain full cognitive control and that this condition is uncontrollable and any outbursts are entirely involuntary.