Bulbar palsy

Wadood Parvez 18:09, 6 October 2007 (UTC)

Bulbar palsy refers to bilateral impairment of function of the lower cranial nerves 9, 10, 11 and 12, which occurs due to lower motor neuron lesion either at nuclear or fascicular level in the medulla or from bilateral lesions of the lower cranial nerves outside the brain-stem. Bulbar Palsy is an assortment of signs and symptoms, not the name of a precise disease.

Causes
-Genetic: Kennedy's disease -Vascular causes: medullary infarction -Degenerative diseases: motor neuron disease, syringobulbia -Inflamatory/infective: Guillain-Barré syndrome, poliomyelitis, Lyme disease -Malignancy: brain-stem glioma

Symptoms
These include: -dysphagia (difficulty in swallowing) -difficulty in chewing -nasal regurgitation -slurring of speech -choking on liquids

Signs
These include: -Nasal speech lacking in modulation and difficulty with all consonants -Tongue is wasted and shows fasciculations. -Dribbling of saliva. -Weakness of the soft palate, examined by asking the patient to say aah. -The jaw jerk is normal or absent. -The gag reflex is absent. -In addition, there may be lower motor neuron lesions of the limbs.

Pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but the damage is occurred in upper motor neurons, that is the nerves cells come down from the cerebral cortex inervating the motor nucleii in the medulla.