Bulbar palsy

Bulbar palsy refers to a range of different signs and symptoms linked to impairment of function of the cranial nerves 9, 10, 11, 12, which occurs due to a lower motor neuron lesion in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem.

dysphagia (difficulty in swallowing)

difficulty in chewing

nasal regurgitation

slurring of speech

difficulty in handling secretions

aspiration of liquids

dysphonia (defective use of the voice, inability to produce sound due to laryngeal weakness)

dysarthria (difficulty in articulating words due to a CNS problem)

nasal speech lacking in modulation and difficulty with all consonants

tongue is atrophic and shows fasciculations.

dribbling of saliva.

weakness of the soft palate, examined by asking the patient to say aah.

normal or absent jaw jerk

absent gag reflex

In addition, there may be lower motor neuron lesions of the limbs.

The ocular muscles are spared and this differentiates it from myasthenia gravis.