What is Pseudobulbar Paralysis?

Pseudobulbar paralysis is a motor condition that may also be referred to as pseudobulbar palsy. It is generally the result of another underlying nervous system condition and can cause any number of physical and emotional complications. Individuals affected with pseudobulbar paralysis exhibit slow speech and and often have difficulty swallowing or chewing. Weakened facial muscles often make the person appear expressionless or without emotion as well. The condition might also cause the individual to experience emotional instability, resulting in inappropriate or sudden bursts of uncontrolled crying or laughter.

This type of paralysis can be the result of a large number of underlying conditions of the nervous system. Causes of pseudobulbar paralysis include vascular problems, such as bilateral hemisphere infarction and CADASIL syndrome. Degenerative disorders, brain stem tumors, and Parkinson’s disease can also lead to pseudobulbar paralysis. Other possible causes include other types of paralysis, such as progressive supranuclear palsy, and some inflammatory diseases, such as multiple sclerosis. When these or other neurologic and nervous system conditions are present, a degeneration of motor neurons may occur, resulting in pseudobulbar paralysis.

Individuals with pseudobulbar paralysis may exhibit awkward or inappropriate emotional outbursts. The condition, for example, may cause a person to burst out in laughter over something that others would not find humorous or cry uncontrollably in a situation that is generally considered only moderately sad. Patients suffering from this condition will often have difficulty performing activities that use the head and neck muscles as well. Other symptoms might include slurred speech, jaw jerks, a stiff and spastic tongue, and an absent or exaggerated gag reflex.

The social ramifications of this condition can result in extreme depression and withdrawal. Daily activities, socializing, and the pursuit of professional careers may all be affected. Individuals who become severely depressed also may neglect overall health and daily hygiene practices. In these instances, counseling or certain medications may be of some help. Medications that may be prescribed to treat the emotional symptoms of the condition include amantadine, fluoxetine, levodopa, and amitriptyline.

Pseudobulbar paralysis is a progressive degenerative condition for which there is no cure. Individuals who suffer from it will typically only worsen over time. Activities such as chewing, swallowing, and speaking will gradually become more difficult. Most often, the symptoms will develop and advance over the course of several years, eventually leading to complete paralysis and disability. Once the patient has become disabled, the risk of aspiration or choking is increased, possibly resulting in severe illness or death.