Progressive Bulbar Palsy

Progressive bulbar palsy (PBP) is a motorneuron disease, which affects |the lower motorneurons responsible for a swallowing, speaking and so on. There are special bulb-shape cells in brain stem, which control it. The lower cranial nerves (IX-XII) are usually damaged.

A typical patient is between 50 and 70 years old. It occurs pretty late and the beginning is slow, but it is highly progressive and people usually die within few years after the onset.



Symptoms

 * muscle weakness (especially pharyngeal, facial and masticatory muscles)
 * loss of speech
 * emotial lability – rapid alternation of laughing and crying
 * tongue muscle atrophy – people are not able to speak or eat, which can be connected with the risk of aspiration pneumonia

Diagnosis
There is no special test for PBP. In differential diagnosis we have to think about myasthenia gravis or cerebral vascular damage (stroke). In most cases the early symptoms are connected with bulbar involvement. In compared to myastenia gravis, where the main problem is a muscle weakness and stroke, where we can usually find some motoric disabilities (hemiplegia). Also Amyotrophic lateral sclerosis can often have some bulbar involvement (in 3/4 of cases).

Pseudobulbar Palsy
It is a group of symptoms, which you can have problem with if you suffer from any other diseases (Parkinson´s disease, stroke, multiple sclerosis). It also includes similar symptoms as PBP – affection of head and neck muscles, swallowing or chewing problems and slurred speech (usually the first symptoms from all).

Therapy
There is no special treatment, so we can just alleviate the symptoms. Physical therapy can help the patient to keep their muscles functional and prevent some muscle spasms. Another option is a medication, which includes especially anti-depressant (against emotial lability) or some analgesics.

Related articles

 * Motorneuron diseases
 * Motor neurons
 * Amyotrophic lateral sclerosis
 * Myasthenia gravis
 * Pneumonia
 * Cranial nerves