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Clinical features of bulbar palsy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Characteristically, the clinical features of bulbar palsy are:

  • atrophy and fasciculations in bulbar muscles:
    • tongue appears wasted and folded; fasciculations are prominent and produce a writhing appearance
    • orbicularis oris is often affected at the same time as the tongue; orbicularis oculi and other facial muscles tend to be affected later and less severely
    • the palate and the extrinsic muscles of the pharynx and larynx are affected after the tongue
    • protrusion of the tongue is weakened and lost
  • dysarthria and dysphonia - from paresis of the lips, tongue and palate; nasal speech is typical
  • dysphagia - food may regurgitate through the mouth; may be most noticeable with fluids
  • jaw jerk and gag reflex are absent

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