All About Multiple Sclerosis

More MS news articles for December 2003

When laughter lingers too long

Inapt tears or laughter side effect of illnesses

Tuesday, December 2, 2003
Richard Ecke
Great Falls Tribute

More than a million Americans suffer from a malady that prompts them to break out laughing at funerals or start crying on happy occasions.

Sharla LaFountain of Great Falls has suffered from the condition called pseudobulbar effect, an offshoot of her multiple sclerosis. Up to 10 percent of people with multiple sclerosis deal with the side effect.

LaFountain, who counsels people at the North Central Montana Independent Living Services in Black Eagle, said the condition caused problems for her at work.

"I work with individual clients," LaFountain said. "You start crying in front of your client, it's kind of difficult."

When LaFountain cried during one counseling session, her concerned client asked, "Can I help you? Are you OK?"

That proved to be a role reversal for the 43-year-old LaFountain.

"They were going to help me instead of me trying to help them," she said.

LaFountain also cried at times when her son played basketball well for Grass Range High School. But that wasn't such a problem.

"Everybody knows me and they say, 'Oh, that's just Sharla,' " she said with a chuckle.

Laughing was troublesome as well.

"I'd start laughing and I'd keep laughing," she said. "Everybody else would be stopped."

LaFountain gained relief when Great Falls neurologist Dennis Dietrich invited her to join a clinical trial in which she took special drugs.

Pseudobulbar effect "is much more common in conditions like ALS," better known as Lou Gehrig's disease, Dietrich said. It also can happen in people who have had strokes or head injuries.

"We're testing a compound that is a combination of two things," Dietrich said. The drugs are dextromethorphan hydrobromide -- "this is the DM in Robitussin DM" -- and quinidine sulfate. The latter helps maintain levels of DM in the body to help counter the effect.

Nearly two-dozen people in Montana are taking the medicine, some from 200 miles away, through Dietrich's office.

"This is the second large study," he said. LaFountain was Dietrich's first patient to enroll in the trial. She believes she is actually receiving the drugs rather than a sugar pill, but she does not know for sure. That's how clinical trials work.

"I do think the study has helped," LaFountain said. "I'm more in control of my emotions. I take one in the morning and one in the evening."

LaFountain is only allowed to stay in the study for 15 months, so her time will end early next year.

Since the trials are still going on, LaFountain may not be able to continue taking a drug that appears to be helping her.

"I guess we'll cross that bridge when we come to it," Dietrich said. He said other already approved drugs are available, although they may not be as effective. His office is accepting people into the trial, and the medicine is provided without charge. Call 727-3720 for details.

Pseudobulbar effect is not a life-and-death matter, but controlling it can help people.

"What a name," LaFountain said with a grin.

LaFountain had a test several months ago in Lewistown.

"I went to my stepmother's funeral," she said. "I was very appropriate."

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