Pseudobulbar palsy
Classification according to ICD-10 | |
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G12.2 | Motor Neuron Disease - Progressive Bulbar Paralysis |
ICD-10 online (WHO version 2019) |
The pseudobulbar is based on a reversible damage to the caudal brain nerve nuclei withdrawing corticonuclear pathways in the brain stem and leading to a central spastic paraparesis of the oral and pharyngeal muscles.
Etiology and pathogenesis
The pseudobulbar paralysis usually arises on the basis of cerebral arteriosclerosis and, as a result, multiple ischemic infarcts in the area of the corticonuclear pathways to the caudal cranial nerve nuclei on both sides ; the cause is accordingly a supranuclear lesion. The bilateral aspect is important because the caudal cranial nerve nuclei receive bilateral central innervation (the cranial nerve nucleus on one side receives fibers from both cerebral hemispheres). In rare cases, multiple sclerosis , ALS, syphilis or multiple brain metastases can also be the cause.
clinic
Similar to "real" bulbar paralysis , dysarthric speech disorders , impaired tongue mobility, swallowing disorders and hoarseness characterize the clinical picture. However, there are no fasciculations , fibrillations and atrophy of the tongue. The masseter reflex can in turn be significantly increased. Often there are also signs of pyramidal tract damage in the extremities. Also characteristic are affect lability and (apparent) affect incontinence with forced laughter and forced crying.
swell
- Delank, Gehlen. Neurology. Stuttgart 2004 ISBN 3-13-129780-8
- Mumenthaler. Neurology. Stuttgart 1990 ISBN 3-13-380009-4