Bulbar palsy

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Bulbar palsy
SpecialtyNeurology Edit this on Wikidata

Bulbar palsy refers to a range of different signs and symptoms linked to impairment of function of the cranial nerves 9, 10, 11, 12, which occurs due to a lower motor neuron lesion in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem.[1]

Signs and symptoms[edit]


  • dysphagia (difficulty in swallowing)
  • difficulty in chewing
  • nasal regurgitation
  • slurring of speech
  • difficulty in handling secretions
  • aspiration of liquids
  • dysphonia (defective use of the voice, inability to produce sound due to laryngeal weakness)
  • dysarthria (difficulty in articulating words due to a CNS problem)


  • 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 reflex

In addition, there may be lower motor neuron lesions of the limbs.

The ocular muscles are spared and this differentiates it from myasthenia gravis.



Differential diagnosis[edit]

In contrast, pseudobulbar palsy is a clinical syndrome similar to bulbar palsy but in which the damage is located in upper motor neurons 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.


Depends on diagnosis

See also[edit]


  1. ^ "Bulbar Palsy". Palsy. Archived from the original on 2011-04-27.
  2. ^ http://www.us.elsevierhealth.com/wilderness-medicine-9781437716788.html[permanent dead link]
  3. ^ http://www.us.elsevierhealth.com/wilderness-medicine-9781437716788.html[permanent dead link]

External links[edit]