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bulbar paralysis (palsy)
Etiology:
1) diphtheria
2) poliomyelitis
3) botulism
4) progressive bulbar palsy
Pathology:
1) degeneration of motor neurons in the brainstem & spinal cord
2) especially affects motor nuclei of cranial nerve 5, cranial nerve 7, cranial nerve 9, cranial nerve 10, cranial nerve 11, & cranial nerve 12
Clinical manifestations:
1) muscle weakness
a) facial muscles & jaw muscles
b) sternocleidomastoid
c) upper part of the trapezius
d) muscles of the tongue, pharynx & larynx
2) atrophy of involved muscles
e) atrophy may not be seen if weakness develops rapidly
3) fasciculations
Differential diagnosis:
-> pseudobulbar palsy
Related
corticobulbar tract
pseudobulbar palsy (spastic bulbar palsy, supranuclear palsy)
General
syndrome
References
- Principles of Neurology, 4th edition, Adams & Victor, McGraw-
Hill, New York, 1989. pg 390, 1088