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Pseudobulbar palsy

From greek.doctor

A pseudobulbar palsy, also called a supranuclear lesion, refers to a bilateral lesion of the corticobulbar tracts. It's the "opposite" of a bulbar palsy.

  • Pathophysiology
    • Cranial nerves V, VII, IX, X, XI, XII are affected
    • Equals an “upper motor neuron” lesion, with typical central motor lesion symptoms like spasticity and hyperreflexia
  • Clinical features
    • Stiff, spastic facial muscles -> no facial expressions
    • Spastic dysarthria (Donald Duck voice)
    • Dysphagia
    • Spastic tongue
    • Pseudobulbar affect/emotional incontinence
      • Uncontrollable laughing or crying
      • Think Joaquin Phoenix in the Joker
    • CN V palsy -> exaggerated jaw jerk reflex
    • Brisk gag reflex