Describe the diagnosis for pseudobulbar palsy.

Expert Answers
Jamie Wheeler eNotes educator| Certified Educator

Let’s begin with a definition of pseudbulbar palsy.  Rather than a single ailment, pseudobulbar palsy affects the mouth and throat, causing difficulties in chewing, swallowing and speech. It also is a nervous system disorder that frequently causes inappropriate emotional outbursts.  There are a number of conditions that include psedubulbar palsy, suchas Parkinson’s disease and multiple scierosis.  It may also accompany amyotrophic lateral sclerosis and stroke, or brain damange because of the “overly rapid correction of low blood sodium levels.”

There are a variety of causes and symptoms of psedubulbar palsy, which can happen when the nervous system experiences degeneration which affects nerve clusters that control movement that exit the brain stem.  Patients who develop psedubulbar palsy will experience progressive difficulties with muscles in the head and neck with are controlled by specific cranial nerves.  Typically, the first noticeable symptom will be impaired speech. Gradually, chewing and swallowing become difficult, and eventually, impossible. Adding to these traumatic symptom are emotional outbursts causes by the malfunctioning nervous system, which may include spontaneous laughter or crying without cause.

Physicians diagnose psedubulbar palsy through the cluster of symptoms with which a patient presents. symptoms. A patient will frequently be sent for a neuroimaging, either a CT or MRI scan determine what underlying neurological problem has led to the development of these symptoms.

A neurologist will care for a patient with psedubulbar palsy, but unfortunately, there is currently no cure. Some medications have been proven to ease symptoms, including levodopa, amantadine, amitriptyline, and fluoxetine but the disease does become progressively more severe and will eventually cause the patient to become completely disabled.

The prognosis, therefore, for pseudobulbar palsy is grim. As the muscles in the neck become increasingly compromised, patients are at a dangerously high risk of choking or aspirating food or liquid into the lungs. Death can result from choking or later, from the development of pneumonia.

Source: Encyclopedia of Neurological Disorders, ©2005 Gale Cengage. All Rights Reserved.

sciencesolve | Student

The pseudobulbar palsy is a neurological disease and it alters the upper motor neurons, responsible with the transmission of signals to the lower motor neurons in the brain stem. This disease affects the ability to swallow, chew and speak. The disease can be caused by tumors, infections, strokes, amyotrophic lateral sclerosis, myasthenia gravis or Parkinson's disease.

The symptoms of pseudobulbar palsy are similar to the symptoms of bulbar atrophy that affects the lower motor neurons in the brain stem. These symptoms include facial muscles weakness, progressive immobility of tongue, emotional lability, progressive loss of speech. The death is imminent within the 3 years because the patients are prone to choking caused by the passage of liquids and food into the lungs.

The management of this disease includes supportive care, physical therapy and teaching of alternative communication methods to help the patients to communicate when the speech is definitively lost.

The diagnosis of pseudobulbar palsy does include a specific test, among the classical neurological exam that evaluates the hearing and speech, the motor and sensory skills, the nerve functions and changes in mood or behavior. This specific test is called Electromyography (EMG) and it is used to assess the degree of modification of sensitivity of lower motor neurons, muscles and peripheral nerves. The EMG is usually performed along with the nerve conduction tests that check the size and speed of the impulses in the nerves.

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