Bulbar palsy

Bulbar palsy refers to a range of different signs and symptoms linked to impairment of function of the cranial nerves 9, 10, 11, 12, which occurs due to a lower motor neuron lesion in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem.[1]

Bulbar palsy
SpecialtyNeurology 

Signs and symptoms

Symptoms
  • dysphagia (difficulty in swallowing)
  • difficulty in chewing
  • nasal regurgitation
  • slurring of speech
  • difficulty in handling secretions
  • aspiration of liquids
  • dysphonia (defective use of the voice, inability to produce sound due to laryngeal weakness)
  • dysarthria (difficulty in articulating words due to a CNS problem)

Signs
  • nasal speech lacking in modulation and difficulty with all consonants
  • tongue is atrophic and shows fasciculations.
  • dribbling of saliva.
  • weakness of the soft palate, examined by asking the patient to say aah.
  • normal or absent jaw jerk
  • absent gag reflex

In addition, there may be lower motor neuron lesions of the limbs.

The ocular muscles are spared and this differentiates it from myasthenia gravis.

Causes

Diagnosis

Differential diagnosis

In contrast, pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but in which the damage is located in upper motor neurons of the corticobulbar tracts in the mid-pons (i.e., in the cranial nerves IX-XII), that is the nerve cells coming down from the cerebral cortex innervating the motor nuclei in the medulla. This is usually caused by stroke.

Treatment

Depends on diagnosis

See also

References
  1. "Bulbar Palsy". Palsy. Archived from the original on 2011-04-27.
  2. http://www.us.elsevierhealth.com/wilderness-medicine-9781437716788.html%5B%5D
  3. http://www.us.elsevierhealth.com/wilderness-medicine-9781437716788.html%5B%5D
Classification
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