Paula Davis expected to work until she was 90 years old.  She was born and raised in Licking County, married her junior high school sweetheart and raised her own daughter in the area.  Despite her size, 4 foot 11 inches, she enjoyed the physical labor of working in a warehouse and was proud to have become a production lead.  In 2015, she was enjoying her work and spending as much time as possible with her grandchildren.  Then, while traveling to celebrate a granddaughter’s birthday, Paula’s vehicle was hit by a truck in a horrific traffic accident.

Paula remembers little about the crash or what happened after she was taken to an area hospital for the numerous, serious injuries she sustained throughout her body including to her face and head.  After recovering in the hospital for four weeks, Paula was sent to a care facility for rehabilitation for another six weeks.  Her grandchildren spent every day with her, and she credits them with motivating her to work hard so that she could return home.  Due to the severity of her injuries, she could no longer work.

Upon returning home, Paula did her best to return to a normal routine.  However, in addition to her physical injuries, she quickly realized something was amiss with her thought processes.  Remembering simple tasks or lists became very difficult, and Paula felt like she was in a fog.  In addition to bouts of confusion, Paula found herself crying uncontrollably or suddenly angry for reasons she could not explain.  She often lashed out at those around her.  Due to the increased risk of stroke and seizures following traumatic brain injury, it was recommended that Paula visit a neurologist.  “The neurologist felt the crying and anger were due to my mental health, and recommended that I visit a therapist,” Paula said.  “I was diagnosed with bipolar disorder and prescribed medication to help my mood.” 

Paula did her best to follow the instructions of the psychiatrist; however, the medications and therapy did not alleviate her hyper-sensitivity to emotional stimuli.  She would still cry for unknown reasons.  “I was most concerned about my anger.  I felt lost and frustrated because I had no control over my brain – especially my memory and emotions.  I just wanted it to stop,” Paula explained.  Late in 2017, while looking for physicians closer to her home, Paula learned Licking Memorial Health Professionals employed a neurologist and quickly contacted the office of Brandon J. Chandos, M.D.  “At my very first appointment, Dr. Chandos spent time with me and carefully listened to all my concerns,” Paula shared.  “He was so sincere and I felt like he really cared about what was happening to me and wanted to help.” 

After considering Paula’s case and symptoms, Dr. Chandos diagnosed her with pseudobulbar affect (PBA).  PBA is a neurological condition involving involuntary, sudden and frequent episodes of laughing, crying or angry outbursts.  The disorder occurs secondary to other neurological disorders including traumatic brain injury, stroke or multiple sclerosis.  The condition generally affects the connection between the frontal lobe, which controls emotions, and the cerebellum and brain stem, where reflexes are mediated.  The outburst may be triggered by an appropriate event or stimulus; however, the response typically is out of proportion, such as exaggerated weeping lasting longer than ordinarily would be expected.  The effects are uncontrollable and also can occur without an emotional trigger.  
 
PBA often is mistaken for mood disorders including depression and bipolar disorder.  Those who experience PBA may feel frustrated, embarrassed, worried and confused by their own behavior.  The disorder has a substantial impact on the lives of those experiencing the condition and on family members and caregivers.  It creates an additional burden for patients who already have a serious underlying neurologic condition.  Once diagnosed, however, pseudobulbar affect can be managed with medication.  Dr. Chandos prescribed Nuedexta, the only medication approved by the Food and Drug Administration that is designed to specifically treat PBA.  “I started taking the medication and it was like a miracle.  I felt like myself again and in control,” Paula happily explained.  “Dr. Chandos saved my life.”  With more control of her emotions, Paula has been doing all she can to help others.  She has been spending as much time as possible with her grandchildren, without fear of uncontrolled angry outbursts.

Neurology is a specialty that focuses on medical problems affecting the nervous system.  Specialized training and experience allow the physicians at Licking Memorial Neurology to treat acute chronic illnesses, including cerebrovascular disease, epilepsy, dementia, headache, tremor, multiple sclerosis and myasthenia gravis.  A wide range of services, both Hospital-based and within the office, are available.  Recently, DeRen Huang, M.D. joined Dr. Chandos at the Licking Memorial Neurology office located at 150 McMillen Drive in Newark.  To make an appointment, call (220) 564-7985.