Bulbar palsy refers to weakness of certain facial muscles. Pseudobulbar palsy is a set of symptoms that resemble bulbar palsy, but has a different cause, some unique symptoms, and requires different treatment approaches.
Bulbar palsy is a general term doctors use to describe weakness of the bulbar muscles, a group of muscles in your face and mouth. This may impair your speech, facial movements, and ability to swallow.
Pseudobulbar palsy is a distinct set of symptoms. Scientists coined the term in
Keep reading to learn more about how these two terms differ.
Pseudobulbar and bulbar palsy share some of the following symptoms:
- difficulty swallowing (dysphagia)
- vocal cord muscle spasms that change your voice (dysphonia)
- slowed, slurred speech (dysarthria)
Pseudobulbar palsy, also known as involuntary emotional expression disorder, also has some of the following symptoms:
- exaggerated facial expressions
- difficulty chewing
- uncontrollable crying or laughing when you don’t feel sad or happy, also known as pseudobulbar affect (PBA)
- emotional lability, where you feel extreme emotions
The symptoms of bulbar palsy may include:
- weakness in your tongue
- lack of a gag reflex
- involuntary jerking of your jaw muscles
Bulbar palsy may be progressive, where the symptoms get worse over time, or it may be non-progressive.
Progressive bulbar palsy
While bulbar palsy is a symptom, you may also hear the term “progressive bulbar palsy,” which is a condition.
Progressive bulbar palsy is a form of motor neuron disease similar to amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease. About
This nerve damage affects your ability to control the muscle movement in your face and mouth.
Damage to the upper motor neurons in your brain and spinal cord causes pseudobulbar palsy.
On the other hand, damage to the lower motor neurons in your peripheral motor nerves causes bulbar palsy.
Some of the conditions that may lead to pseudobulbar palsy include:
Conditions that may lead to bulbar palsy include:
To diagnose pseudobulbar or bulbar palsy, a doctor will ask about your medical history and perform a physical exam. During this exam, the doctor will check your:
- ability to control your facial muscles
- emotional expressiveness
Based on the results of your physical exam, a doctor may recommend some of the following procedures:
- MRI or CT scan of your brain
- electroencephalogram (EEG) to detect any brain cell communication problems
- a complete blood count, including a serologic test to check for antibodies in your blood
- cerebral spinal fluid (CSF) analysis collected via a spinal tap
If you think you may have pseudobulbar palsy, be sure to tell a doctor if you are experiencing uncontrolled emotional outbursts. PBA is
There’s no cure for either pseudobulbar or bulbar palsy, but you can manage these symptoms with treatment.
A doctor may treat bulbar palsy as follows:
- prescribe anticholinergic drugs, such as benztropine mesylate (Cogentin) or oxybutynin (Ditropan XL), to help prevent drooling
- prescribe riluzole (Rilutek) to help reduce some nerve damage and respiratory symptoms
- perform a gastrostomy by inserting a feeding tube into your stomach to help improve your digestion of nutrients (if the disease progresses)
Note that the FDA has approved riluzole to treat ALS only.
For pseudobulbar palsy, a doctor may prescribe:
How long you experience pseudobulbar and bulbar palsy depends on the underlying cause. For example, if pseudobulbar palsy is due to a stroke, your symptoms may improve over time.
But if your symptoms are due to a progressive disorder, they may slowly worsen.
Although they’re not the same neurological condition, there’s no cure for either pseudobulbar or bulbar palsy.
However, medications and rehabilitative therapy may help you manage the symptoms and improve your quality of life.