Bulbar palsy
Appearance
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