A disorder of upper motor neurons or their descending tracts to motor neurons in the brainstem can result in pseudobulbar palsy.


Synonym: supranuclear palsy


Muscles affected:

(1) jaw

(2) tongue

(3) soft palate

(4) pharynx

(5) larynx

(6) face


Clinical findings in affected muscles:

(1) spasticity

(2) mild weakness

(3) mild slowing of movements

(4) hyperreflexia (brisk jaw jerk)


Functions affected:

(1) speaking and articulating

(2) chewing (mastication)

(3) swallowing (deglution)


An important diagnostic finding is emotional lability (emotional incontinence) with an emotional stimulus triggering abnormal laughing or crying.


Differential diagnosis:

(1) bulbar palsy (associated with injury to the lower motor neurons)


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