What Is Pseudobulbar Palsy?

Pseudobulbar palsy is caused by bilateral upper motor neuron damage (mainly the motor cortex and its cortical brain stem bundles) causing the medullary motor cranial nucleus, the suspected nucleus and the pontine trigeminal motor nucleus, to lose upper motion Neuronal dominance is caused by central paralysis. The clinical manifestations are central paralysis of the tongue, soft palate, throat, face, and chewing muscles. Its symptoms are very similar to those of bulbar paralysis, but they are not caused by the medulla. Pseudobulbar palsy.

Pseudoball paralysis

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Speech difficulties: The essence is dysarthria, which is mainly caused by movement paralysis and hypertonia of the lips, tongue, soft palate, and throat. Is a kind of speech blur.
Difficulty in voicing: very characteristic patient's personal characteristics disappeared, monotonous, low-dumb, rough and dull. Or vice versa
Difficulty eating: If food enters the pharyngeal cavity, swallowing will still be completed smoothly.
The patient's expression is indifferent, and about half of them have unexplained, uncontrollable episodes of strong crying and laughing, which are common
The expression is special. When alone, the expression is indifferent, as if indifferent to the surroundings. Due to the expression of hypertonic muscles, patients often open their eyes and wrinkles and open their mouths, showing a sad expression with little change and monotony.
When stimulated, they are in a state of inactivity, their expressions change rapidly, and even strong crying and laughing attacks occur (essentially the release of the respiratory center, a state of asphyxia caused by spasm of the respiratory muscles and facial muscles. This state happens to be crying or laughing It looks like it can't be considered an emotional incontinence). Mechanical stimuli such as pain and temperature cannot be induced, but are often induced by a certain degree of emotional activity. Some stimuli that should not cause emotional activity at all, such as calling their names, can be induced, and they are always the same in a patient. State performance.
Cortex, subcortical type:
Damage site: both sides
Pseudoball paralytic feeding-swallowing disorder
Pseudobulbar palsy is severely disturbed during the feeding-swallowing preparation period and oral period, and chewing, lumps formation, and lumps transfer are difficult. However, there is still a certain degree of swallowing reflex. Although the swallowing reflex appears to be slow after moving to the pharyngeal stage, once it is induced, subsequent swallowing movements will occur in sequence. This time difference can cause swallowing. Due to the frequent complications of advanced brain dysfunction, the symptoms are: I don't know the order of eating, repeat the same movement, talking during eating increases the risk of swallowing, it is easy to ignore food on the side of the table, and the tongue and masseter muscles are normal but unable to swallow. Food inside.
True ball paralysis feeding-swallowing disorder
Ball paralysis is caused by lesions that damage the medulla swallowing center of the brainstem. The feeding-swallowing disorder mainly occurs in the pharyngeal stage, and the induction of swallowing reflex is extremely weak or even disappears. There are no obstacles or minor obstacles during the antecedent, preparation, and even oral periods. Often swallowing is prominent. The representative disease is Wallenberg Syndrome. Due to insufficient elevation of the larynx and poor expansion of the esophagus, the ring-shaped pharyngeal muscles are not sufficiently loosened, leading to the retention of esophagus in the pharynx, which often occurs after swallowing.


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