Patho- Bulbar disease Flashcards
What is bulbar palsy?
LMN weakness of muscles whose cranial nerve nuclei lie in the medulla (the bulb)
What can cause bulbar palsy?
Damage to lower cranial nerve nuclei- IX, X, XII
What nerves can be damaged in bulbar palsy?
IX, X, XII
What can cause LMN damage in bulbar palsy?
Lesions
Impaired transmission:
Myasthenia gravis
Botulism
What are some symptoms of bulbar palsy?
Decreased tone
Muscle wasting
Fasciculation
Diminished reflexes
What is a differential for bulbar palsy?
Pseudobulbar palsy?
What is pseudobulbar palsy?
Bilateral supranuclear (UMN) lesions of lower cranial nerves
What are some symptoms of pseudobulbar palsy?
Tongue weakness Pharyngeal weakness Dysarthria with a stiff, slow voice sounding dry and gravelly Dysphagia Gag and palatal reflexes are preserved Exaggerated jaw jerk Emotional lability
Describe tongue weakness in pseudobulbar palsy?
Stiff, slow and spastic but not wasted
No fasciculations
What can cause pseudobulbar palsy?
MND
MS
Cerebrovascular disease
Trauma
What three things can differentiate bulbar palsy from pseudobulbar palsy?
Tongue
Jaw jerk
Gag reflex
How does the tongue differ in bulbar palsy from pseudobulbar palsy?
Bulbar- wasted and fasciculations
Pseudo- Spastic
How does the jaw jerk differ in bulbar palsy from pseudobulbar palsy?
Bulbar- Normal
Pseudo- Brisk
How does the gag reflex differ in bulbar palsy from pseudobulbar palsy?
Bulbar- Reduced
Pseudo- Exaggerated
