There are 486 questions on various topics in Neurology in the FrontalCortex neurology question bank.

Bulbar Signs and Symptoms 01

Topic: Adult

Created on Sunday, September 28 2008 by jdmiles

Last modified on Sunday, September 28 2008.

A patient presents with dysphagia and dysarthria. The tongue shows atrophy and fasciculations. Sensation and gag are intact. The jaw-jerk reflex is very brisk. Of the following, which is the best description of these findings?

 
        A) Bulbar palsy
 
        B) Pseudobulbar palsy
 
        C) Glossopharyngeal palsy
 
        D) Hypoglossal palsy
 
        E) Progressive bulbar palsy
 

 


Back to the question = Go back to the top of the page.
See another question like this one = Reload a different version of this question ().
Click here for a random question = Load a random question from the database.
Clone this question = Use this question as a template to create a totally NEW question.
Rate this question = Enter detailed rating for this question!
Average user rating for this question = 4 = How users like you have rated this question.
This question was created on September 28, 2008 by jdmiles.
This question was last modified on September 28, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Bulbar palsy

This answer is incorrect.


Bulbar palsy refers to dysarthria, dysphagia, and labio-palatal-glosso-pharyngeal weakness due to damage to the lower motor neurons of the bulb (medulla). These nerves are CN IX, CN X, CN XI, and CN XII. The brisk jaw-jerk and intact gag in this case implicates damage to upper, not lower motor neurons. Thus, this would be a pseudobulbar palsy.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




B) Pseudobulbar palsy

This answer is correct.


Bulbar palsy refers to dysarthria, dysphagia, and labio-palatal-glosso-pharyngeal weakness due to damage to the lower motor neurons of the bulb (medulla). These nerves are CN IX, CN X, CN XI, and CN XII. The brisk jaw-jerk and intact gag in this case implicates damage to upper, not lower motor neurons. The lesion exists rostral to the medulla, e.g., in the cortex. Thus, this would be a pseudobulbar palsy.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




C) Glossopharyngeal palsy

This answer is incorrect.


The presence of a brisk jaw-jerk reflex and atrophied tongue suggests that there is more going on here than an isolated Glossopharyngeal palsy.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




D) Hypoglossal palsy

This answer is incorrect.


The presence of a brisk jaw-jerk reflex suggests that there is more going on here than an isolated Hypoglossal palsy.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




E) Progressive bulbar palsy

This answer is incorrect.


Bulbar palsy refers to dysarthria, dysphagia, and labio-palatal-glosso-pharyngeal weakness due to damage to the lower motor neurons of the bulb (medulla). These nerves are CN IX, CN X, CN XI, and CN XII. The brisk jaw-jerk and intact gag in this case implicates damage to upper, not lower motor neurons, making this a pseudobulbar palsy. Progressive bulbar palsy is a disease of motor neurons that presents with - you guessed it - a progressive course of bublar palsy. No such progressive course has been described in this case.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

References:

1. Rowland, L.P. (Ed) (2000). Merritt's Neurology, 10th Edition. Lippincott Williams & Wilkins, Philadelphia. (ISBN:0683304747)Advertising:
2. Malcolm Parsons, Michael Johnson. Diagnosis in colour: neurology. Edinburgh ; Mosby, 2001. (ISBN:0723431795)Advertising:
Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
adult
Bulbar Signs and Symptoms 01
Question ID: 092808189
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 09/28/2008
Modified: 09/28/2008
Estimated Permutations: 120

User Comments About This Question:

0 user entries
Please log in if you'd like to add a comment.