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Defintion
- A.k.a. bulbar paralysis
- Weakness or paralysis of muscles innervated by motor nuclei of lower brainstem
- Affects muscles of face, tongue, larynx, and pharynx
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Etiology
Result of tumors, vascular or degenerative diseases of lower cranial nerve motor nuclei (i.e. ALS)
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Examine/Determine
- Glossopharyngeal and vagal paralysis: phonation, articulation, palatal action, gag, swallowing
- Changes in voice quality: dysphonia (hoarseness or nasal quality)
- Bilateral involvement: severe airway restriction with dyspnea, difficulty with coughing
- Possible complications: aspiration pneumonia
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Pseudobulbar Palsy
- Bilateral dysfunction of corticobulbar innervation of brainstem nuclei
- Central or UMN lesion analogous to corticospinal lesions disrupting function of anterior horn cells
- Produces similar symptoms as bulbar palsy
- Examine for hyperactive reflexes (increased jaw jerk and snout reflex (tapping on lips produces pouting)
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PT Goals, Outcomes, and Interventions
- Suctioning, oral care
- Maintenance of respiratory function, open airway
- Elevate head of bead
- Dietary changes = soft foods, liquids
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