Pseudobulbar palsy

Overview
Pseudobulbar palsy is bilateral impairment of the function of the lower cranial nerves 9, 10, 11 and 12 due to upper motor neurone lesion of the bulbar muscles from lesions of the corticobulbar pathways in the pyramidal tract.

Causes

 * Vascular causes: Bilateral hemisphere infarction
 * Degenerative disorders: motor neuron disease
 * Inflammatory disorders: Multiple sclerosis
 * Malignancy: High brain stem tumors

Symptoms
These include:
 * Dysphagia (difficulty in swallowing)
 * Labile affect
 * Dysarthria

Signs
These include:
 * Speech is slow, thick and indistinct
 * Gag reflex is normal or exaggerated
 * Tongue is small, stiff and spastic
 * Jaw jerk is brisk
 * There may be upper motor neurone lesion of the limbs.

Bulbar palsy is a similar disorder but is caused by lower motor neurone lesions