Bulbar palsy is seen in
A. Myesthania gravisB. Motor neuron disease
C. Arsenic poisoning
D. Lead poisoning
E Polio
The Answer is. (A) Myasthenia gravis ; (B) Motor
neuron Disease ; (E) Polio
* Bulbar palsy is the weakness of LMN type of muscles
whose cranial nerve nuclei lie in the medulla (the bulb). Weakness of bulbar muscles
is caused by disease of:
— Lower cranial nerve nuclei (e.g. Motor Neuron
Disease (MND))
—Ninth to twelve cranial nerves.
— Their neuromuscular junctions (e.g. myasthenia
gravis, botulism)
----The muscles themselves
• Causes of IXth to XlIth nerve lesions
(i) With in the brain-stem (ii) At skull base
— Infraction —
Ca nasopharynx
----Syringobulbia —
Glomus tumour
— Motor neuron disease — Neurofibroma
— Polio myelitis —
Jugular venous thrombosis
— Trauma
(iii) Within the neck and nasopharynx
— Ca Nasopharynx
— Metastases
----Polyneuropathy
— Trauma.
Causes of
pseudobulbar palsy :
•MND
• Multiple sclerosis
• CVA (Typically multi-infarct dementia)
• Following Head injury
In pseudobulbar palsy
* Jaw jerk—brisk.
* Palatal and gag reflex –
preserved
* Stiff, slow, spastic
tongue
* Dysarrthria with a stiff,
slow voice sounding dry and gravelly
* Dysphagia.
