This tutorial explains the difference in mechanisms between the 2 palsies. Bulbar palsy is a lower motor neuron condition and pseudobulbar palsy is an upper motor neuron condidtion.
Thank you so much for this presentation. I am an SLP student and this video helps me very much with the understanding of Flaccid and Spastic dysarthria. Thanks again
Excellent. My friend developed "progressive bulbar paralysis " after a polio vaxxine in 1959 and was in an iron lung for awhile. Luckily, he recovered 95%.
Thanks for the question! Muscle twitching, or fasciculations, can occur in any skeletal muscle and are caused by contractions of a muscle group that is served by a single motor nerve fiber. The motor nerve fibers are lower motor neurons, so we associate fasciculations with lower motor neuron lesions. If the lower motor neural control of the skeletal muscle is impaired, fasciculations can result. (continued)
thank you very much . This is so kind of you. I highly appreciate your kind efftorts. In this part of world, where we don't have access to the medical educational materials, you come to us as a ray of hope. Oncee again thank you very much
Useful to note the presence of flaccid dysarthria (speech) in people with bulbar palsy, which could include the hypernasal resonance and/or raspy vocal quality you described with weakness of the soft palate.
Hi, Pseudobulbar palsies are bilateral because of bilateral innervation. Bulbar palsy causes tend to be disease related (muscle or nerve disorders) which would present bilaterally. In the presence of a unilateral bulbar palsy, I would strongly consider a space-occupying lesion/tumor. Best regards, LB
Hi. Thanks for the video and resource. Quick question. When you say Cranial nerve XI do you mean CN IX? CN XI, spinal accesory innervates the trapezius muscles and the sternocleidomastoid. CN IX (Glossopharengeal) is involved with swallowing and gag reflex
Hi Sarah, The following is from: Brain (2001) Pathological laughter and crying: A link to the cerebellum. Vol 124, Iss 9, pp1708-1719: The traditional and currently accepted view is that PLC is due to the damage of pathways that arise in the motor areas of the cerebral cortex and descend to the brainstem to inhibit a putative centre for laughter and crying. In that view, the lesions `disinhibit' or `release' the laughter and crying centre...continued
The critical PLC lesions occur in the cerebro-ponto-cerebellar pathways. THis is what allows the laughter without humorous context. I hope this helps. LKB
For further clarification, note that the lower motor neuron structures include the Cranial Nerve XII nuclei which function like the anterior horn cells in the cord. Both house the cell bodies of the peripheral nerves that ensue. The nerve itself is also a lower motor neuron structure, so damage in any of these structures can result in fasciculations. (continued)
Hi, I do mention that gag reflex is absent (diminished) and I do note that that the jaw jerk is normal. I believe that your textbook is incorrect in stating that the jaw jerk is absent because of the explanation I give at 7:22: CN V anfd CN VII are exluded in bulbar palsy. I hope this helps!
The upper motor neuron structures include anything from the motor cortex through the corticobulbar tract prior to synapsing on the nuclei. Damage along this pathway will result in spasticity of the tongue. I hope this is helpful...
Hello dr thank you very much for this video i have a question why there is not an alteration of the upper half of the face despite the bilateral alteration of the supranucleus pathways
Hi! Water is not necessary in testing for bulbar palsy, but the patient may complain of fluid finding its way up the nasopharynx when swallowing. The nasal tone of the voice in a bilateral bulbar palsy is due paresis of the soft pallet due to cranial nerve X involvement. As a result, air during speech is allowed to escape through the nose. I hope this is helpful.
Excellent video. Really useful way of explaining these conditions! One question, i have written down in my notes that in End stage multiple sclerosis you will get pseudobulbar palsy (because of demyelination within CNS). However can patients present with pseudobulbar symptoms?
Demyelination of the connections between the primairy motor neuron (in the cortex) and the secundairy motor neuron (in the brain stem). White matter is also bart of the corticobulbair tract :)
Thank you so much for this great video! But just a quick question... are the same results seen in the SCM and traps as well i.e. spasticity and fasciculations and atrophy or not due to collateral innervation? thank you again! :D
I don’t know if I have Pseudobulbar but I probably don’t cause it triggers when I feel so stressed or when my mom barges in my privacy or when she tells me off and falsely accuses me. When she left the room, my head throbbed on one side and I bent down, randomly tears starting falling and I tried to wipe it off but it kept falling again and then I started laughing while crying. All I could think was how to leave, how to die, how to kill, how to end it all, how to be strong, how to be happy, etc.
Good video, however The corticospinal tract carries motor signals from the primary motor cortex in the brain, down the spinal cord, to the muscles of the trunk and limbs. ... The corticobulbar tract carries efferent, motor, information from the primary motor cortex to the muscles of the face, head and neck. They are not the same thing.
Yes, cranial nerve V and VII nuclei are in the brainstem, but are involved in pseudobulbar palsy and not bulbar palsey. Let me know if you need further explanation or if I did not understand your question.
pretty much the same thing. in normal people jaw jerk is absent and it's normal. but some people can have slightly present jaw jerk and it still can be normal.
i am not medically trained. My memory fades and i am emmotionally Highly strung. My neuro fails to make a final diagnoses even though they ar "the best" in the area. My situation is apperantly UNIQUE???
My mother has been diagnosed with PBP and she exhibits excessive crying and emotional distress that she cannot articulate as to why she is crying. Is this another symptom?
Hello, my name is David. I have been diagnosed with MND Vs MultiFocal motor Nueropathy,I am being treated with IGIV Immunoglobulin, I believe i have MND as I am no responding to the treatment. Symptoms..Fasiculations Face, limbs body and tongue. My Gag reflex was initially over reactive and has dimminished to under active. Forgive my terminoligy,
