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Symptoms and Signs – Differential Diagnosis of Bulbar and pseudobulbar palsy
Bulbar palsy: cranial nerves {IX, X, XII) lesions at three different levels:
Nuclei (brainstem): vascular, infection (e.g. polio encephalitis), syringobulbia,
tumour
Nerve: motor neurone disease, meningeal infiltration, Guillain-Barre syndrome
Muscle: myasthenia gravis, muscular dystrophy, polymyositis
Pseudobulbar palsy: bilateral UMN lesions to the lower brainstem
Vascular disease (involving both hemispheres)
Multiple sclerosis
Motor neurone disease
Malignancy
Extrapyramidal disease
Bulbar palsy: cranial nerves {IX, X, XII) lesions at three different levels:
Nuclei (brainstem): vascular, infection (e.g. polio encephalitis), syringobulbia,
tumour
Nerve: motor neurone disease, meningeal infiltration, Guillain-Barre syndrome
Muscle: myasthenia gravis, muscular dystrophy, polymyositis
Pseudobulbar palsy: bilateral UMN lesions to the lower brainstem
Vascular disease (involving both hemispheres)
Multiple sclerosis
Motor neurone disease
Malignancy
Extrapyramidal disease
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