Bulbar Palsy Flashcards
What is bulbar palsy?
A range of different signs and symptoms linked to impairment of function of CN IX - XII due to LMN lesion in the medulla oblongata or lesions of the lower cranial nerves outside the brainstem
What parts of the oral cavity are required for speech?
- Larynx
- Pharynx
- Palate
- Tongue
- Lips
As well as components of the oral cavity, what else is required for speech?
Controlled expiration to release air at appropriate speeds and volumes
Via what do the motor cortices send signals to initiate speech?
Corticobulbar tracts
What nerves are involved in speech production?
- Vagal nerve (CN X)
- Facial nerve (CN VII)
- Hypoglossal nerve (XII)
- Phrenic nerve
How are the motor aspects of speech co-ordinated?
By the extra-pyramidal system via the basal ganglia and the cerebellum
What are the two aspects of speech production (motor aspects)?
- Phonation
- Articulation
What is phonation?
The production of sound as a result of the vocal cords in the larynx
What is articulation?
Contractions of the muscles of the various other structures involved in speech
Why is articulation important?
Muscle contractions change the sounds from the larynx to result in noises recognised as words
What are the types of causes of Bulbar palsy?
- Genetic
- Vascular causes
- Degenerative diseases
- Inflammatory/infective
- Malignancy
- Toxic
- Autoimmune
What are the genetic causes of Bulbar palsy?
- Kennedy’s disease
- Acute intermittent porphyria
Give 1 vascular cause of Bulbar palsy?
Medullary infarction
What are 2 degenerative disease that can cause Bulbar palsy?
- Amyotrophic lateral sclerosis
- Syringobulbia
Give 3 infective/inflammatory causes of Bulbar palsy?
- Guillain-Barre syndrome
- Poliomyelitis
- Lyme disease