Supranuclear bulbar palsy (pseudobulbar palsy) in mitral stenosis.
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Brain Diseases↗
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Results for “Pseudobulbar Palsy”
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Bilateral perisylvian ulegyria: clinicopathological study of patients presenting with pseudobulbar palsy and epilepsy.
Structural abnormalities related with pseudobulbar palsy have been gaining attention because of their characteristic symptoms and unique pathogenesis. We present five cases of bilateral perisylvian ulegyria (BPU) presenting epilepsy and pseudobulbar palsy with pathogenesis different from previously reported syndromes. All patients showed medically intractable seizures, complex partial seizures with secondary generalization and clinical symptoms of pseudobulbar palsy, including dysarthria, limitation of tongue movement and drooling. MRI revealed BPU in all patients, and BPU associated with hippocampal sclerosis in four patients. Intracranial EEG recording with subdural grip and stripe was helpful for localizing the area of ictal generation. Resective surgeries, including the temporal lobe, central area and parietal lobe, were performed depending on the localizing information. The surgical outcome was favorable after 9.8 years of follow-up. Characteristic features of ulegyria were confirmed on pathological examination. Ulegyria is considered to be another important perinatal or postnatal structural abnormality which can explain the etiological heterogeneity for pseudobulbar palsy, which results from bilateral perisylvian lesions. Awareness of this disorder can provide a useful strategy for evaluation and treatment which differs from that in perisylvian polymicrogyria.
Adult↗
Relation between cognitive dysfunction and pseudobulbar palsy in amyotrophic lateral sclerosis.
OBJECTIVES: To examine the relation between cognitive dysfunction and pseudobulbar features in patients with amyotrophic lateral sclerosis (ALS). METHODS: The performance of two patient groups, ALS with pseudobulbar palsy (n = 24) and ALS without pseudobulbar palsy (n = 28), was compared with 28 healthy age matched controls on an extensive neuropsychological battery. Tests used were the national adult reading test, short form of the WAIS-R, recognition memory test, Kendrick object learning test, paired associate learning, Wisconsin card sorting test, verbal fluency, Stroop and negative priming tests, a random movement joystick test, and a computerised Tower of Hanoi test. RESULTS: Tests of executive function showed a pronounced deficit on written verbal fluency in both ALS groups in comparison to controls, which tended to be more prominent in patients with ALS with pseudobulbar palsy. The random movement joystick test (a non-verbal test of intrinsic movement generation) showed an impairment in the generation of random sequences in patients with pseudobulbar palsy only. The computerised Tower of Hanoi showed a subtle planning impairment (shorter planning times) in all the patients with ALS compared with controls on trials requiring more complex solutions. In addition the pseudobulbar patients displayed shorter planning times on complex trials, and tended to solve these trials less accurately. There was also evidence of a deficit for all patients with ALS in comparison with controls on total errors and number of categories achieved on the Wisconsin card sorting test and a strong tendency towards an impairment on a task of selective attention and cognitive inhibition (negative priming). A word recognition memory deficit was showed across both ALS groups. CONCLUSIONS: This study elicited cognitive deficits (involving predominantly executive processes, with some evidence of memory impairment) in patients with ALS and further strengthened the link between ALS and frontal lobe dysfunction, this being more prominent in patients with pseudobulbar palsy. However, cognitive impairments suggestive of extramotor cortical involvement were not exclusive to this subgroup.
Adult↗
[Observation on clinical therapeutic effect of acupuncture on apoplectic pseudobulbar palsy].
OBJECTIVE: To find a clinically effective therapy for apoplectic pseudobulbar palsy. METHODS: Seventy-five cases of apoplectic pseudobulbar palsy were randomly divided into 3 groups, acupuncture group, western medicine group and acupuncture plus medicine group. They were treated for one month. RESULTS: The scores for clinical symptoms and signs, and the clinical scores for water provocative test in the acupuncture plus medicine group and the acupuncture group were superior to that in the western medicine group with significant difference (P < 0.01), and the therapeutic effects of the 3 groups were related with age, course of disease and condition of illness. CONCLUSION: Acupuncture has some predominances in treatment of apoplectic pseudobulbar palsy.
Acupuncture Therapy↗
Left atrial myxoma presenting as pseudobulbar palsy.
A case of left atrial (LA) myxoma presenting as pseudobulbar palsy, due to multiple cerebral infarcts, without any cardiac manifestations, is presented. LA myxoma is rare cause of embolization to CNS causing ischemic infarcts. Due to multiple CNS infarcts patient can present with varied clinical picture and pseudobulbar palsy is not a very common presentation. It was a real diagnostic dilemma before LA myxoma was diagnosed on echocardiography.
Adult↗
Bilateral thalamic infarcts presenting as acute pseudobulbar palsy.
A 28-year-old, previously healthy, normotensive woman suddenly developed an acute pseudobulbar palsy with dysarthria, dysphagia, hypernasal voice and mild right arm paresis. Extensive laboratory investigations excluded all other possible causes of acute pseudobulbar palsy (neoplastic, inflammatory, demyelinative, myasthenic) and an MRI study demonstrated bilateral isolated thalamic infarcts. Oral contraceptives and smoking were the only possible stroke risk factors found and cerebral diaschisis the most tenuous explanation proposed. To our knowledge, this is the first report indicating that bilateral thalamic infarction on specific nuclei could be manifested as acute pseudobulbar palsy.
Adult↗
[Treatment of 120 cases of pseudobulbar palsy of wind-phlegm type with needling method for dispelling wind and expelling phlegm].
OBJECTIVE: To observe clinical therapeutic effects of needling method for dispelling wind and expelling phlegm on pseudobulbar palsy of wind-phlegm type. METHODS: Two hundred and forty cases of pseudobulbar palsy of wind-phlegm type were randomly divided into an observation group and a control group, 120 cases in each group, and they were treated by needling method for dispelling wind and expelling phlegm, and intravenous dripping of cytidine diphosphate choline injection plus blank needling method, respectively. One month later, main symptoms and signs were systematically compared and assessed. RESULTS: The cured rate and the total effective rate were 40.7% and 89.0% in the observation group respectively, which were superior to 7.6% and 37.0% in the control group (P < 0.01). CONCLUSION: The needling method for dispelling wind and expelling phlegm has obvious therapeutic effect on pseudobulbar palsy of wind-phlegm type.
Acupuncture Points↗
Acute pseudobulbar palsy as the initial presentation of intravascular lymphomatosis.
We describe the case of a 76-year-old male patient who developed acute manifestations of pseudobulbar palsy without a history of stroke or vascular risk factors as the first manifestation of intravascular lymphomatosis. Neurological symptoms of acute pseudobulbar palsy appeared on the second postoperative day after transurethral prostatectomy for the treatment of prostatic hypertrophy. Intravascular lymphomatosis was diagnosed from microscopic findings and immunohistochemical staining of the surgical specimen. Chemotherapy was started, but the patient died due to sepsis secondary to bone marrow aplasia. Intravascular lymphomatosis should be considered a rare potential cause of acute pseudobulbar palsy.
Journal Article↗
Pseudobulbar palsy associated with trismus.
A 60 year old patient presented with an acute pseudobulbar palsy associated with trismus. A computed tomography scan revealed low attenuation areas consistent with infarction affecting the genu of the internal capsules bilaterally. Trismus has not previously been described as the presenting feature of a pseudobulbar palsy.
Brain↗
Neoplastic obstruction of the trachea complicating pseudobulbar palsy.
We have reported a case of pseudobulbar palsy with airflow obstruction initially attributed to chronic aspiration and chronic airflow obstruction caused by cigarette smoking. The finding of stridor led to a detailed evaluation of the obstruction. Flow-volume loops, fiberoptic bronchoscopy, CT scan of the upper thorax, and fine-needle biopsy of a lesion of the trachea were required to make the diagnosis of non-small-cell carcinoma involving the trachea.
Airway Obstruction↗
Lacunae and cribriform cavities of the brain. Correlations with pseudobulbar palsy and parkinsonism.
Fifty-one brains showing lacunae and 30 with cribriform cavities have been identified out of 191 examined brains. A histologic and immunohistochemical study with the peroxidase-antiperoxidase method for glial fibrillary acidic protein has been carried out in selected cases. The number, site, associated arterial lesions and the microscopic appearance of lacunae and cribriform cavities are reported. Lacunae are small cavities usually, but not always due to softenings; cribriform cavities are dilatations of the perivascular space. Two types of cribriform cavities have been identified, according to the histological appearance of the surrounding tissue: type 1 with normal and type 2 with rarefied and abnormally gliotic surrounding nervous tissue. Sixteen cases showing a cribriform state in the basal ganglia exhibited a pseudobulbar palsy or extrapyramidal rigidity. Pseudobulbar palsy of striate form or parkinsonism may be ascertained in some cases only by histological and immunohistochemical examination.
Aged↗
[Progressive supranuclear palsy with apraxia of the eyelid, dementia, pseudobulbar palsy, nuchal rigidity, hyperreflexia and unsteady gait].
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Apraxias↗
Primary antiphospholipid syndrome presenting as pseudobulbar palsy in a young male.
Antiphospholipid antibody syndrome (APS) is now recognized as an important risk factor for young stroke. Recurrent stroke seems to be common in patients with APS and a first stroke, recurrent stroke and vascular dementia are feared consequences of APS. We are reporting a case of primary APS with recurrent stroke presenting as pseudobulbar palsy in an young man.
Adult↗
Pseudobulbar palsy after posterior fossa operation in children.
The authors describe their experience with an unusual postoperative syndrome of pseudobulbar palsy occurring a few days after the extirpation of large midline vermian/4th ventricular tumors in children. The patients had a delayed onset of supranuclear cranial nerve palsies associated with emotional incontinence and lability that resolved over several weeks to months. It is postulated that retraction pressure on the medial cerebellum and split vermis is the operative insult responsible for edema that subsequently tracked along fiber pathways in the middle and superior cerebellar peduncles into the upper pons and midbrain. Modifications of operative technique to eliminate the need for retraction are presented.
Adolescent↗
Control of emotional expression in pseudobulbar palsy. A personal experience.
This report is based on the recorded experience of a patient with lability of emotional expression and other features of the syndrome of pseudobulbar palsy. We describe severe emotional overflow despite an underlying affective tone that is normal. In this context, emotional lability is a misnomer. "Hyperactive emotional reflexes" would be a more appropriate descriptive term, as the underlying mood appears normal, and only the degree of emotional expression is pathological.
Bulbar Palsy, Progressive↗
Pseudobulbar palsy caused by a large petroclival meningioma: report of two cases.
Two patients sought treatment for symptoms of bulbar motor dysfunction and the marked emotional lability that characterizes pseudobulbar palsy (PBP). Magnetic resonance (MR) imaging showed large petroclival masses with severe compression and displacement of the brainstem. A suboccipital craniectomy with a transpetrosal, transtentorial approach to the tumor was performed in both patients. One patient required a second-stage surgery to resect an extension of the tumor into the cavernous sinus. In both patients pathological evaluation confirmed the diagnosis of syncytial meningioma. After surgery, PBP resolved in both patients. Large posterior fossa tumors should be included in the differential diagnosis of patients with a clinical picture of bulbar motor dysfunction coupled with emotional lability.
Case Reports↗
PROGRESSIVE SUPRANUCLEAR PALSY. A HETEROGENEOUS DEGENERATION INVOLVING THE BRAIN STEM, BASAL GANGLIA AND CEREBELLUM WITH VERTICAL GAZE AND PSEUDOBULBAR PALSY, NUCHAL DYSTONIA AND DEMENTIA.
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Basal Ganglia↗
Bilateral central macrogyria: epilepsy, pseudobulbar palsy, and mental retardation--a recognizable neuronal migration disorder.
The neuronal migration disorders comprise several morphological entities that are recognizable during life using current imaging techniques. We studied 4 patients who had a characteristic bilateral central rolandic and sylvian macrogyria. The patients had pseudobulbar palsy with oromotor incoordination and developmental delay and were mildly retarded. Minor seizures developed between the ages of 8 and 9 years. Subsequently, atonic drop attacks became the predominant epileptic pattern. Epileptogenic electrographic abnormalities were secondary generalized or multifocal. The lesions were detected by computed tomography and magnetic resonance imaging in all patients. Bilateral symmetrical areas of thick cortex surrounding a large sulcus were seen. This syndrome consists of specific clinical, imaging, electroencephalographic, and epileptic features. It can be suspected clinically and confirmed by imaging studies. Callosotomy in two patients helped the intractable seizures.
Adolescent↗