Pseudobulbar palsy
Encyclopedia
Pseudobulbar palsy results from an upper motor neuron lesion to the corticobulbar pathways in the pyramidal tract. Patients have difficulty chewing, swallowing and demonstrate slurred speech (often initial presentation). Individuals with pseudobulbar palsy also demonstrate inappropriate emotional outbursts.

Causes

  • Vascular
    Vascular
    Vascular in zoology and medicine means "related to blood vessels", which are part of the circulatory system. An organ or tissue that is vascularized is heavily endowed with blood vessels and thus richly supplied with blood....

     causes: Bilateral hemisphere infarction, CADASIL syndrome
  • Progressive Supranuclear Palsy
    Progressive supranuclear palsy
    Progressive supranuclear palsy is a degenerative disease involving the gradual deterioration and death of specific areas of the brain....

  • Amyotrophic lateral sclerosis
    Amyotrophic lateral sclerosis
    Amyotrophic lateral sclerosis , also referred to as Lou Gehrig's disease, is a form of motor neuron disease caused by the degeneration of upper and lower neurons, located in the ventral horn of the spinal cord and the cortical neurons that provide their efferent input...

     (ALS)
  • Parkinson's disease
    Parkinson's disease
    Parkinson's disease is a degenerative disorder of the central nervous system...

  • Multiple System Atrophy (related to Parkinson's disease)
  • Degenerative disorders: motor neuron disease
  • Inflammatory
    Inflammation
    Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

     disorders: Multiple sclerosis
    Multiple sclerosis
    Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...

  • Malignancy: High brain stem
    Brain stem
    In vertebrate anatomy the brainstem is the posterior part of the brain, adjoining and structurally continuous with the spinal cord. The brain stem provides the main motor and sensory innervation to the face and neck via the cranial nerves...

     tumors
  • Metabolic causes: osmotic demyelination syndrome

  • Brain trauma

Symptoms

These include:
  • Dysphagia
    Dysphagia
    Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia....

     (difficulty in swallowing)
  • Labile affect
  • Dysarthria
    Dysarthria
    Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system and is characterized by poor articulation of phonemes...


Signs

These include:
  • Speech is slow, thick and indistinct
  • Gag reflex
    Gag reflex
    The pharyngeal reflex or gag reflex is a reflex contraction of the back of the throat, evoked by touching the soft palate or sometimes the back of the tongue. It prevents something from entering the throat except as part of normal swallowing and helps prevent choking...

     is normal, exaggerated or absent
  • Tongue
    Tongue
    The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...

     is small, stiff and spastic
    Spastic
    The word spastic is used differently depending on location which has led to some controversy and misunderstanding. Derived via Latin from the Greek spastikos , the word originally referred to a change in muscles affected by the medical condition spasticity, which is seen in spastic diplegia and...

  • Jaw jerk is brisk
  • There may be upper motor neuron lesion of the limbs.


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

External links

- "pseudobulbar palsy" - "comparison of bulbar and pseudobulbar palsy"
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