Understanding and Managing ALS (Amyotrophic Lateral Sclerosis)

6. Emotional and respiratory issues

Some people with ALS will experience pseudobulbar affect, which are unintended or uncontrollable emotional displays, like laughing or crying. The pseudobulbar effect is caused by damage to the brain and is more common in those with bulbar onset ALS. This type of ALS mainly affects the neurons in the bulbar region of the brainstem, which controls the facial and neck muscles and processes like swallowing and speech. This part of the brain contains the brain's breathing center. As the disease progresses, breathing problems worsen. The respiratory muscles weaken, and the person becomes unable to breathe independently. It also becomes more difficult for them to cough and expel phlegm to clear the airway.