Pseudobulbar palsy

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Pseudobulbar palsy
ICD-9	335.23
DiseasesDB	10826
MeSH	D020828

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

External links

248512525 at GPnotebook - "pseudobulbar palsy"
456458269 at GPnotebook - "comparison of bulbar and pseudobulbar palsy"
eNotes

v • d • e Pathology of the nervous system, primarily CNS (G00-G47, 320-349)
Inflammatory diseases of the CNS	Meningitis (Arachnoiditis) - Encephalitis - Myelitis - Encephalomyelitis (Acute disseminated) - Tropical spastic paraparesis
Systemic atrophies primarily affecting the CNS	Huntington's Spinocerebellar ataxia (Friedreich's ataxia, Ataxia telangiectasia, Hereditary spastic paraplegia) Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio Londe - MND (ALS, PMA, PBP, PP, PLS)
Extrapyramidal and movement disorders	Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration Dystonia/Dyskinesia (Spasmodic torticollis, Meige's, Blepharospasm) Essential tremor - Myoclonus - Lafora Chorea (Choreoathetosis) - Restless legs - Stiff person
Other degenerative / demyelinating diseases	Alzheimer's - Pick's - Alpers' - Dementia with Lewy bodies - Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis
Seizure/epilepsy	Focal (Simple partial, Complex partial) - Generalised (Tonic-clonic, Absence, Atonic, Benign familial neonatal) Lennox-Gastaut - West - Epilepsia partialis continua - Status epilepticus (Complex partial status epilepticus)
Headache	Migraine (Familial hemiplegic) - Cluster - Vascular - Tension
Vascular	Transient ischemic attack (Amaurosis fugax, Transient global amnesia) Cerebrovascular disease (MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke)
Sleep disorders	Insomnia - Hypersomnia - Sleep apnea (Ondine's curse) - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase
Other	Intracranial hypertension: Hydrocephalus (Normal pressure) - Idiopathic intracranial hypertension Encephalopathy - Brain herniation - Cerebral edema - Reye's - Syringomyelia - Syringobulbia - Spinal cord compression