There are different types of clinical presentations, including progressive bulbar palsy (PBP), Limb-onset ALS, progressive muscular atrophy (PMA) and upper motor neuron (UMN) predominant ALS. PBP has mainly brainstem signs. [cambridge.org]

Nasal regurgitation may be present. Dysphonic. Dysphagic. Emotional lability may also be present. There may also be neurological deficits in the limb - eg, increased tone, enhanced reflexes and weakness. [patient.info]

We present a case of sarcoidosis with a unique presentation of isolated bulbar palsy. [cureus.com]

Auditory involvement is usually not present in progressive bulbar palsy. [accessanesthesiology.mhmedical.com]

Both bulbar and pseudobulbar palsy are seen mainly in men over 75 years old and present with dysarthria and dysphagia. [amboss.com]

• Heart Disease

  The risk of stroke is increased by high blood pressure, older age, smoking, diabetes, high cholesterol, heart disease, atherosclerosis (a build-up of fatty material and plaque inside the coronary arteries), and a family history of stroke. [fpnotebook.com]

• Stroke

  Infectious neuropathies: poliomyelitis, diphtheria, neurosyphilis Stroke (multiple, recurrent strokes) Neurodegenerative disease: amyotrophic lateral sclerosis, progressive supranuclear palsy, multiple sclerosis Injury or malignancy of the high brainstem [amboss.com]

  Pseudobulbar palsy due to bilateral injuries of corticobulbar tracts in a stroke patient. Int J Stroke. 2015 Aug;10(6):E53-4. 5. Loeb C, Gandolfo C, Caponnetto C, et al. Pseudobulbar palsy: a clinical computed tomography study. [neurosigns.org]

  (Cerebrovascular Accident), Apoplexy, Cerebrovascular, Cerebrovascular Apoplexy, Cerebral Stroke, Cerebral Strokes, Stroke, Cerebral, Strokes, Cerebral, Cerebrovascular Stroke, Cerebrovascular Strokes, Stroke, Cerebrovascular, Strokes, Cerebrovascular [fpnotebook.com]

  Pseudobulbar palsy is most often linked to: stroke motor neuron disease multiple sclerosis cerebrovascular disorders If you’ve experienced any of the following conditions, you may be at risk of developing pseudobulbar palsy: stroke motor neuron disease [healthline.com]

  In differential diagnosis we have to think about myasthenia gravis or cerebral vascular damage (stroke). In most cases the early symptoms are connected with bulbar involvement. [wikilectures.eu]

• Guillain-Barré Syndrome

  Antiganglioside antibody in patients with Guillain-Barré syndrome who show bulbar palsy as an initial symptom. J Neurol Neurosurg Psychiatry. 1999; 66: 513-516 Hughes R.A. Cornblath D.R. Guillain-Barré syndrome. [pedneur.com]

  Subtypes and variants Bulbar palsy Pseudobulbar palsy Etiology Brainstem stroke or tumors Neurodegenerative diseases: amyotrophic lateral sclerosis, syringobulbia, multiple sclerosis Autoimmune neuropathies: Guillain-Barré syndrome, myasthenia gravis [amboss.com]

  Multiple cranial neuropathy variant of Guillain-Barré syndrome: A case series. Muscle Nerve 2011;44:252-7. 8. Gordon PH, Wilbourn AJ. Early electrodiagnostic findings in Guillain-Barré syndrome. Arch Neurol 2001;58:913-7. [pediatricneurosciences.com]

  Degenerative diseases: amyotrophic lateral sclerosis, syringobulbia, Wolfram syndrome Inflammatory/infective: Guillain–Barré syndrome, poliomyelitis, Lyme disease Malignancy: brain-stem glioma, malignant meningitis Toxic: botulism, venom of bark scorpion [en.wikipedia.org]

  Bulbar Palsy can be caused by any of the following conditions: Cerebrovascular - medullary infarction Motor neuron disease High brain stem tumors Head injury Toxin – Botulism Neurosyphilis Inflammatory – Guillain-Barré syndrome, Lyme disease Subacute [newyorkfacialparalysis.com]

• Nasal Speech

  Signs of Bulbar Palsy Absent jaw jerk Absent palate rise Absent pharyngeal reflex Tongue wasting and fasciculations Flaccid dysarthria - nasal speech with impaired articulation and shortened phrases Causes of Bulbar Palsy Motor neurone disease Guillain-barré [medschool.co]

  [edit] nasal speech lacking in modulation and difficulty with all consonants tongue is atrophic and shows fasciculations. dribbling of saliva. weakness of the soft palate, examined by asking the patient to say aah. normal or absent jaw jerk absent gag [en.wikipedia.org]

  Signs & Symptoms Symptoms dysphagia (difficulty in swallowing) difficulty in chewing nasal regurgitation slurring of speech difficulty in handling secretions choking on liquids dysphonia (defective use of the voice, inability to produce sound due to laryngeal [m.blog.naver.com]

  speech emotions are not affected pseudobulbar palsy normal or increased reflexes - gag reflex and jaw jerk spastic weakness - small, tight tongue that cannot be protruded “Donald Duck” speech labile emotions bilateral upper motor limb signs other differential [ozemedicine.com]

• Quadriplegia

  […] body part or a disturbance in the functioning of a social group; "erectile dysfunction"; "sexual relationship dysfunction" paresis - a slight or partial paralysis paraplegia - paralysis of the lower half of the body (most often as a result of trauma) quadriplegia [thefreedictionary.com]

  The authors present a case of acute intermittent porphyria (AIP) in an almost fatal relapse with quadriplegia, bulbar paralysis and coma [3]. [wikigenes.org]

• Apraxia

  Injury of this tract can lead to several types of language impairment, including conduction aphasia, Broca's aphasia, anomic aphasia, and apraxia of speech (Anderson et al., 1999; Bartha and Benke, 2003; Catani and Mesulam, 2008; Bernal and Ardila, 2009 [nrronline.org]

  Injury of this tract can lead to several types of language impairment, including conduction aphasia, Broca’s aphasia, anomic aphasia, and apraxia of speech [25-28]. [omicsonline.org]

Workup for poliovirus was negative. Daily physiotherapy was started under supervision. [pediatricneurosciences.com]

Packard Center for ALS Research at John Hopkins offers further general information on treatment: http://www.alscenter.org/what-is-als/treatment/index.html The Mayo Clinic provides information on treatment of ALS in general, which may be helpful: http: [rarediseases.info.nih.gov]

Treatment will be directed to the underlying cause. Postural changes can help with drooling of saliva and may prevent aspiration. [patient.info]

Bulbar palsy and pseudobulbar palsy Summary Epidemiology Subtypes and variants Diagnostics Treatment [amboss.com]

Pisa syndrome during aripiprazole treatment: a case report. [pedneur.com]

As there is no cure for Bulbar Palsy, treatment is essentially limited to medical management and support. [newyorkfacialparalysis.com]

IBP patients appear to have a relatively benign prognosis and longer survival compared to PBP.[sup][5],[6] It is important to distinguish IBP from PBP for prognosis prediction, patient care, and even treatment options. [go.gale.com]

Prognosis This depends on the underlying cause. [patient.info]

Clinical features and prognosis of Miller Fisher syndrome. Neurology. 2001; 56: 1104-1106 Uysalol M. Tatlı B. Uzel N. Çıtak A. Aygün E. Kayaoğlu S. [pedneur.com]

ICD-9: 335.22 ICD-10: G12.22 PROGRESSION The prognosis for PBP is poor. The symptoms of PBP slowly worsen with onset beginning between the ages of 50-70 years. [secure.ssa.gov]

Because the condition is degenerative, the prognosis for PBP is fairly poor. [disability-benefits-help.org]

CSF analysis and MRI of the brain help identify the etiology. Treatment is mainly supportive. Epidemiology References:[1][2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Etiology Pseudobulbar palsy is not a disease but a clinical constellation. Clinical conditions that involve corticobulbar tracts bilaterally can cause pseudobulbar palsy.[3] Many pathological conditions can lead to pseudobulbar palsy. [statpearls.com]

Although much has been learned about the etiologic factors involved in the acute forms of bulbar paralysis,2 anterior poliomyelitis and associated diseases, the cause of true progressive bulbar palsy is just as obscure today as when the condition was [jamanetwork.com]

Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. [fpnotebook.com]

Epidemiology References:[1][2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

[…] subsets]. 61 Pradat PF...Bruneteau G 17128087 2006 32 Masseter spasticity successfully treated with neuroablations of the bilateral mandibular nerves for a patient with progressive bulbar palsy. 61 Fujiwara Y...Shimada Y 16116026 2005 33 Clinical and epidemiological [malacards.org]

He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education. [litfl.com]

Pseudobulbar palsy epidemiology depends on the cause that has lead to corticobulbar pathway damage. [statpearls.com]

Epidemiology of the post-polio syndrome. Am J Epidemiol. 1992 Oct 1. 136(7):769-86. [Medline]. Takemura J, Saeki S, Hachisuka K, Aritome K. Prevalence of post-polio syndrome based on a cross-sectional survey in Kitakyushu, Japan. [medscape.com]

Nervous system disorders resulting from therapeutic radiation are described, and potential pathophysiologic mechanisms underlying myokymia are discussed. (C) 2000 John Wiley and Sons, Inc. [mayoclinic.pure.elsevier.com]

Infectious neuropathies: poliomyelitis, diphtheria, neurosyphilis Stroke (multiple, recurrent strokes) Neurodegenerative disease: amyotrophic lateral sclerosis, progressive supranuclear palsy, multiple sclerosis Injury or malignancy of the high brainstem Pathophysiology [amboss.com]

Amelioration of the underlying disease process Prevention of complications Improvement of swallowing via therapy Compensations to improve swallowing safety and efficiency & 5. [slideshare.net]

Physical therapy can help the patient to keep their muscles functional and prevent some muscle spasms. Another option is a medication, which includes especially anti-depressant (against emotial lability) or some analgesics. [wikilectures.eu]

Postural changes can help with drooling of saliva and may prevent aspiration. [patient.info]

These affected nerves become damaged, preventing the messages from the nerve reaching the muscles causing weakness and muscle wasting. [southtees.nhs.uk]

Our case highlights the importance of considering sarcoidosis as a possible cause of bulbar palsy; timely efforts are needed to confirm the diagnosis and treat the condition to prevent any permanent neurological damage. [cureus.com]