Bulbar Palsy

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Bulbar Palsy

• lower motor neuron lesion affecting swallowing and speech
• (c.f. Pseudobulbar Palsy)

Examination

• Cranial Nerve
  • IX/ X
    • poor palatal movement
    • loss of gag reflex
  • XII
    • weak / wasted tongue
    • fasciculation
• Speech
  • poor quality
  • nasal
• Cough
  • poor cough impulse
  • nasal regurgitation on swallowing

Causes

• Motor Neurone Disease
• Syringobulbia
• Guillain-Barre Syndrome
• Medulla lesions
  • vascular
  • demyelinating
  • tumour

(similar picture in Myasthenia Gravis)

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