Progressive bulbar palsy

Clinic

• PBP belongs to motor neuron diseases. It is located under the umbrella of Bulbar palsy since it attacks the nerves supplying of bulbar muscles.
• It is characterized by the degeneration of motor neurons in the cerebral cortex, spinal cord, brain stem and pyramidal tracts.
• This specifically involves the Glossopharyngeal nerve (IX), Vagus nerve (X), and Hypoglossal nerve (XII).
• ICD-11 lists progressive bulbar palsy as a variant of ALS

Signs / Symptoms

• Glossopharyngeal nerve: Reduced gag reflexes
• Vagus nerve: Weak palatal movements
• Hypoglossal nerve:
  • Fasciculations
  • Progressive difficulty with talking and swallowing
  • Weak movement of the facial muscles and tongue
  • Difficulty with pronunciations, particularly lateral consonants (linguals) and velars
  • Problems with drooling saliva
• If corticobulbar tract is affected a Pseudobulbar affect may occur

Related disease

• Pseudobulbar palsy
• Progressive spinal muscular atrophy
• 25% of patients eventually develop ALS

Miasms /

• Paralysis, Bulbar
• Mouth, Speech , Difficult
• Dysphagia
• Mouth, Paralysis, Soft palate

Entities

PLV