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Pseudobulbar palsy is a condition that causes a lack of control of the muscles in your face. When it happens to a person, it can be confusing and scary, especially since there are other conditions similar to it, like bulbar palsy.
We’re going to look more closely at this condition from its origins and symptoms to its diagnosis and treatment.
Our aim is to take some of the confusion and fear out of this condition and help you get back on track.
What Is Pseudobulbar Palsy?
Pseudobulbar palsy is a medical condition that causes loss of control of many of the muscles in the face and the mouth. It tends to be progressive, usually starting with slurred speech due to loss of control of the tongue. And, it can get as bad as having issues with chewing and swallowing as the condition progresses.
What Are the Causes of Pseudobulbar Palsy?
Pseudobulbar palsy is caused by damage (bilateral degeneration) to the neurons of the brain stem, in particular, the corticobulbar tract. The damage is usually the result of another medical condition. These medical conditions can include:
- Multiple system atrophy disorders such as Parkinson’s disease
- Vascular causes like bilateral hemispheric infarction and CADASIL syndrome
- Progressive supranuclear palsy
- Amyotrophic lateral sclerosis
- Multiple sclerosis and other inflammatory disorders
- Various motor neuron diseases, commonly those involving demyelination
- Metabolic causes, such as osmotic demyelination syndrome
- High brain stem tumors
- Cerebrovascular disorders
- Progressive supranuclear palsy
- Amyotrophic lateral sclerosis
- Behçet’s disease, a rare multisystem inflammatory disorder
- Trauma to the brain, including a stroke
Symptoms of Pseudobulbar Palsy
People afflicted with pseudobulbar palsy slowly lose control of their facial muscles, including the tongue, lips, and throat. As the condition progresses, the following symptoms tend to appear:
- Dysphagia (difficulty in swallowing)
- Spastic tongue
- Slurred speech, sometimes to the point of incomprehension
- Jerky jaw movements
- Labile affect
In some cases, the gag reflex may be completely normal, but in others, it may become exaggerated or become absent. It’s also not unusual for someone with pseudobulbar palsy to suffer from the occasional lack of control of emotions resulting in spontaneous emotional outbursts.
Diagnosis of Pseudobulbar Palsy
When diagnosing pseudobulbar palsy, the doctor will do a close examination of the facial muscles. This includes examining tongue movement or lack thereof, as well as an examination of the jaw. Doctors will also make a note of any sudden emotional outburst. A magnetic resonance imaging (MRI) test will often be done to confirm the diagnosis, as well as to see if there are issues within the brain.
Pseudobulbar Palsy vs. Bulbar Palsy
One of the issues with properly diagnosing pseudobulbar palsy is that the symptoms are very similar to bulbar palsy. While there are a few symptoms that differ (e.g., bulbar palsy sufferers don’t have sudden emotional outbursts), the difference between bulbar and pseudobulbar palsy lies in the location of the brain damage.
Bulbar palsy is caused by impairment of the function of the IX, X, XI and XII cranial nerves due to a lower motor neuron lesion in the medulla oblongata. So, while they share similar qualities and symptoms, pseudobulbar palsy and bulbar palsy are caused by damage in two different parts of the brain.
Pseudobulbar Palsy Treatment
Unfortunately, there is no cure for pseudobulbar palsy, but there are two ways you can manage it. The first is treating the underlying condition that is causing the palsy in the first place. Treating the underlying cause may help lessen the severity of the symptoms.
The second way is to try and manage the symptoms of pseudobulbar palsy by using medications. These can include tricyclic antidepressants, serotonin reuptake inhibitors, dextromethorphan, and quinidine sulfate.
Don’t Give Up Hope
Pseudobulbar palsy is a medical condition that makes life difficult. In addition to medications to help reduce symptoms, you will more than likely have to look into alternative methods of communication, as there will be times that speech will fail you.
Medical science is working on different medications and treatments all the time. There may not be a cure within your lifetime, but there’s a chance there may be something in the pipeline to make things easier. So, don’t give up hope.
Sources:
“Pseudobulbar Palsy,” MediGoo; https://www.medigoo.com/articles/pseudobulbar-palsy/, last accessed August 3, 2017.
“Pseudobulbar Palsy,” Wikipedia; https://en.wikipedia.org/wiki/Pseudobulbar_palsy, last accessed August 3, 2017.
Stubblefield, H., “Pseudobulbar Palsy,” Healthline, June 15, 2016; http://www.healthline.com/health/pseudobulbar-palsy#overview1, last accessed August 3, 2017.