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Bulbar palsy

From greek.doctor

A bulbar palsy, also called a nuclear lesion, is a bilateral lesion of the motor nucleus of a cranial nerve, its axon, or its NMJ. A bulbar palsy is the "opposite" of pseudobulbar palsy.

  • Pathophysiology
    • Cranial nerves IX, X, XI, and XII are affected
    • Equals a “lower motor neuron” lesion, with typical peripheral motor lesion symptoms like atrophy and flaccidity
  • Clinical features
    • Normal facial expressions (because VII is unaffected)
    • Nasal speech
    • Dysphagia of fluids
    • Atrophic and fasciculating tongue
    • Absent gag reflex