Bulbar palsy: Difference between revisions

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=== Clinic ===
=== Clinic ===


* It refers to a range of different Signs / Symptoms linked to impairment of function of 
* Bulbar palsy is an entity which involve cranial nerves 9,10,11,12. 
*#[[Glossopharyngeal nerve]] (CN IX)  
*#[[Glossopharyngeal nerve]] (CN IX)  
*#[[Vagus nerve]] (CN X)  
*#[[Vagus nerve]] (CN X)  
*#[[Accessory nerve]] (CN XI)  
*#[[Accessory nerve]] (CN XI)  
*#[[Hypoglossal nerve]] (CN XII)  
*#[[Hypoglossal nerve]] (CN XII)  
* [[Motor Neuron Disease|Motor Neuron Diseases]] have this entity
** [[Progressive bulbar palsy]]
** [[Pseudobulbar palsy]]
* It is caused by a Lower motor neuron lesion in [[medulla oblongata]], or from lesions to these nerves outside [[brainstem]].
* It is caused by a Lower motor neuron lesion in [[medulla oblongata]], or from lesions to these nerves outside [[brainstem]].


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*[[Dysphagia remedies|Dysphagia]]
*[[Dysphagia]]
* Difficulty in chewing
* Difficulty in chewing
* Nasal regurgitation
* Nasal regurgitation
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=== Causes ===
=== Causes ===
 
{| class="wikitable"
!Dynamic
!Static
|-
|
*Degenerative diseases: [[ALS, Amyotrophic Lateral Sclerosis remedies|ALS]], Syringobulbia, Wolfram syndrome
* Inflammatory/ Infective:
** [[GBS, Guillian Barre syndrome|Guillain–Barré syndrome]]
** [[PLV, Polio Virus|PLV]]
** [[LBB, Lyme Borreliosis Bacterium|Lyme disease]]
* Autoimmune: [[Myasthenia gravis]]
|
* Genetic: Kennedy's disease, Acute intermittent porphyria.
* Genetic: Kennedy's disease, Acute intermittent porphyria.
* Vascular causes: medullary infarction
* Vascular causes: medullary infarction
* Degenerative diseases: [[ALS, Amyotrophic Lateral Sclerosis remedies|ALS]], Syringobulbia, Wolfram syndrome
* Inflammatory/ Infective: [[GBS, Guillian Barre syndrome|Guillain–Barré syndrome]], [[PLV, Polio Virus|PLV]], [[LBB, Lyme Borreliosis Bacterium|Lyme disease]]
* Cancer: Brainstem glioma, Malignant meningitis
* Cancer: Brainstem glioma, Malignant meningitis
* Toxic: botulism, venom of bark scorpion
* Toxic: botulism, venom of bark scorpion
* Autoimmune: [[Myasthenia gravis]]
|}
 
 
=== Related Disease ===
 
* [[Myasthenia gravis]]:The ocular muscles are spared Bulbar Palsy and this differentiates it from MG.
* [[Pseudobulbar palsy]]: Pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but in which the damage is located in [[UMNS, Upper Motor Neuron Syndrome entities|UMN]] of the corticobulbar tracts in the mid-pons (i.e., in the cranial nerves IX-XII), that is the nerve cells coming down from the cerebral cortex innervating the motor nuclei in the medulla. This is usually caused by stroke.




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=== Related disease ===
=== Related disease ===
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* [[Motor Neuron Disease]]
* [[Motor Neuron Disease]]
*[[Progressive bulbar palsy]]
*[[Progressive bulbar palsy]]
*[[Myasthenia gravis]]:The ocular muscles are spared Bulbar Palsy and this differentiates it from MG.
* [[Pseudobulbar palsy]]: Pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but in which the damage is located in [[UMNS, Upper Motor Neuron Syndrome entities|UMN]] of the corticobulbar tracts in the mid-pons (i.e., in the cranial nerves IX-XII), that is the nerve cells coming down from the cerebral cortex innervating the motor nuclei in the medulla. This is usually caused by stroke.




=== Miasms ===
=== Miasms ===


* '''PLV''': It is the most important miasm
* CXA
* CXA
* EV70
* EV70
* PLV

Revision as of 05:38, 14 April 2023

Clinic


Signs /Symptoms

Symptoms Signs
  • Dysphagia
  • Difficulty in chewing
  • Nasal regurgitation
  • Difficulty in handling secretions, including aspiration of liquids
  • Difficulty breathing (Airway obstruction)
  • Dysphonia (Inability to produce sound due to laryngeal weakness)
  • Dysarthria ( such as slurred speech.
  • May be LMN lesions of the limbs.
  • Flaccid paralysis, such as soft palate weakness
  • Muscle atrophy, such as tongue atrophy with fasciculations.
  • Nasal speech lacking in modulation and difficulty with all consonants.
  • Drooling of saliva
  • Normal or absent jaw jerk
  • Reduced or absent gag reflex


Causes

Dynamic Static
  • Genetic: Kennedy's disease, Acute intermittent porphyria.
  • Vascular causes: medullary infarction
  • Cancer: Brainstem glioma, Malignant meningitis
  • Toxic: botulism, venom of bark scorpion


Entities / Miasms

PLV CXA EV70 CJD NVCJD FFI

Paralysis, Bulbar

+++ +++ +++
Dysarthria

Mouth/ Speech difficult / Speech nasal

Nasal speech

+++ +++ +++ +++
Dysphagia +++ +++ +++ +++
Face, Plasy +++
LMN:
  • Softe palate paralysis
  • Muscular atrophy
  • Fasciculations
  • Hypo Reflexia
 +++

Related disease

  • GERD
  • Motor Neuron Disease
  • Progressive bulbar palsy
  • Myasthenia gravis:The ocular muscles are spared Bulbar Palsy and this differentiates it from MG.
  • Pseudobulbar palsy: Pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but in which the damage is located in UMN of the corticobulbar tracts in the mid-pons (i.e., in the cranial nerves IX-XII), that is the nerve cells coming down from the cerebral cortex innervating the motor nuclei in the medulla. This is usually caused by stroke.


Miasms

  • PLV: It is the most important miasm
  • CXA
  • EV70
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