284:. Nuedexta is an FDA approved medication for pseudobulbar affect. Dextromethorphan, an N-methyl-D-aspartate receptor antagonist, inhibits glutamatergic transmission in the regions of the brainstem and cerebellum, which are hypothesized to be involved in pseudobulbar symptoms, and acts as a sigma ligand, binding to the sigma-1 receptors that mediate the emotional motor expression.
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can also be performed. It has been suggested that the majority of patients with pathological laughter and crying have pseudobulbar palsy due to bilateral corticobulbar lesions and often a bipyramidal involvement of arms and legs. To further confirm the condition, MRI can be performed to define the
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controlling laughter and crying, proposing that a reciprocal pathway exists between the cerebellum and the brain stem that adjusts laughter and crying responses, making them appropriate to context. The pseudobulbar crying could also be induced by stimulation in the region of the
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is a medical condition characterized by the inability to control facial movements (such as chewing and speaking) and caused by a variety of neurological disorders. Patients experience difficulty chewing and swallowing, have increased
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Since pseudobulbar palsy is a syndrome associated with other diseases, treating the underlying disease may eventually reduce the symptoms of pseudobulbar palsy.
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region, and demonstrate slurred speech (which is often the initial presentation of the disorder), sometimes also demonstrating uncontrolled emotional outbursts.
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Graham KC, Spiegel DR (2008). "Pseudobulbar palsy and affect in a case of progressive multifocal leukoencephalopathy".
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to the lower brain stem. This damage might arise in the course of a variety of neurological conditions that involve
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Diagnosis of pseudobulbar palsy is based on observation of the symptoms of the condition. Tests examining
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Okun MS, Raju DV, Walter BL, Juncos JL, DeLong MR, Heilman K, et al. (June 2004).
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355:"Pseudobulbar palsy caused by a large petroclival meningioma: report of two cases"
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pathways that course from the cerebral cortex to nuclei of cranial nerves in the
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Possible pharmacological interventions for pseudobulbar affect include the
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Bourgouin PM, Chalk C, Richardson J, Duang H, Vezina JL (August 1995).
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431:"Subcortical white matter lesions in osmotic demyelination syndrome"
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Spinal muscular atrophy with lower extremity predominance (SMALED)
16:"Pseudobulbar" redirects here. For the emotional condition, see
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The proposed mechanism of pseudobulbar palsy points to the
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The condition is usually caused by the bilateral damage to
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Asfora WT, DeSalles AA, Abe M, Kjellberg RN (April 1989).
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The
Journal of Neuropsychiatry and Clinical Neurosciences
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and bilateral corticobulbar lesions. Examples include:
330:"Bulbar and Pseudobulbar Palsy. What is Bulbar Palsy?"
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86:Signs and symptoms of pseudobulbar palsy include:
137:Pseudobulbar palsy is the result of damage of
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402:Saleem, Fatima; Munakomi, Sunil (2024).
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1481:Distal hereditary motor neuronopathies
1154:Template:Demyelinating diseases of CNS
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1332:Idiopathic intracranial hypertension
121:may be normal, exaggerated or absent
1563:Infantile progressive bulbar palsy
14:
1266:Template:Cerebrovascular diseases
1069:Frontotemporal lobar degeneration
353:McCormick WE, Lee JH (May 2002).
276:, and a novel approach utilizing
1286:For more detailed coverage, see
1264:For more detailed coverage, see
1235:For more detailed coverage, see
1201:For more detailed coverage, see
1152:For more detailed coverage, see
99:Small, stiff and spastic tongue
206:osmotic demyelination syndrome
154:Progressive supranuclear palsy
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1579:Amyotrophic lateral sclerosis
1464:Hereditary spastic paraplegia
1322:Normal pressure hydrocephalus
274:serotonin reuptake inhibitors
176:, especially those involving
159:Amyotrophic lateral sclerosis
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257:areas of brain abnormality.
210:Neurological involvement in
1058:Primary progressive aphasia
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1380:Hashimoto's encephalopathy
1086:Posterior cortical atrophy
907:Striatonigral degeneration
758:Cavernous sinus thrombosis
96:(difficulty in swallowing)
90:Slow and indistinct speech
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1486:Spinal muscular atrophies
1454:Primary lateral sclerosis
1312:Intracranial hypertension
1092:Creutzfeldt–Jakob disease
488:10.1176/jnp.2008.20.1.110
270:tricyclic antidepressants
126:upper motor neuron lesion
1553:Progressive bulbar palsy
1344:Intracranial hypotension
1327:Choroid plexus papilloma
741:Herpesviral encephalitis
527:10.1136/jnnp.2003.016485
1065:Frontotemporal dementia
751:Encephalitis lethargica
410:. StatPearls Publishing
168:multiple system atrophy
124:Examination may reveal
1370:Hepatic encephalopathy
371:10.1055/s-2002-31568-1
1610:Motor neuron diseases
1428:Ataxia–telangiectasia
1385:Static encephalopathy
1108:Mitochondrial disease
946:Spasmodic torticollis
856:Basal ganglia disease
576:10.1136/jnnp.52.4.523
174:motor neuron diseases
1375:Toxic encephalopathy
1081:Lewy bodies dementia
404:"Pseudobulbar Palsy"
309:Motor neuron disease
70:pathways, which are
1423:Friedreich's ataxia
806:Meningoencephalitis
746:Limbic encephalitis
303:lower motor neurons
294:Corticobulbar tract
238:subthalamic nucleus
164:Parkinson's disease
141:traveling from the
18:Pseudobulbar affect
1459:Pseudobulbar palsy
1197:Status epilepticus
1148:Multiple sclerosis
985:Myoclonic epilepsy
848:movement disorders
794:Acute disseminated
736:Viral encephalitis
204:Metabolic causes:
183:Multiple sclerosis
82:Signs and symptoms
72:upper motor neuron
59:in tongue and the
48:Pseudobulbar palsy
29:Pseudobulbar palsy
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1406:Degenerative
1143:Inflammatory
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834:Degenerative
731:Encephalitis
714:Inflammation
704:, primarily
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412:. Retrieved
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365:(2): 67–71.
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337:. Retrieved
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299:Bulbar palsy
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217:Brain trauma
187:inflammatory
166:and related
139:motor fibers
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128:of the limbs
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1558:Fazio–Londe
1398:Both/either
1192:Generalised
1051:Early-onset
1046:Alzheimer's
781:spinal cord
414:20 February
1166:paroxysmal
1138:Autoimmune
931:Dyskinesia
801:Meningitis
779:Brain and
653:DiseasesDB
408:StatPearls
359:Skull Base
339:2016-03-26
315:References
254:gag reflex
199:brain stem
185:and other
119:Gag reflex
109:Dysarthria
76:brain stem
57:spasticity
1163:Episodic/
1041:Tauopathy
992:Akathisia
980:Myoclonus
963:Athetosis
895:Tauopathy
261:Treatment
244:Diagnosis
189:disorders
94:Dysphagia
40:Neurology
35:Specialty
1604:Category
1529:SMALED2B
1524:SMALED2A
1221:Migraine
1213:Headache
1179:epilepsy
1175:Seizures
1033:Dementia
936:Dystonia
545:15146017
496:18305298
389:17167648
288:See also
250:jaw jerk
172:Various
104:jaw jerk
53:reflexes
1541:SMA-PME
1536:SMA-PCH
1519:SMALED1
1231:Tension
1226:Cluster
951:Meige's
768:Amoebic
647:D020828
594:2738597
585:1032309
536:1739063
457:7484639
448:8338057
380:1656925
334:Patient
231:of the
1260:Stroke
1074:Pick's
1001:Tremor
968:Chorea
636:335.23
592:
582:
543:
533:
494:
455:
445:
387:
377:
201:tumors
133:Causes
102:Brisk
61:bulbar
1574:both:
1506:DSMA1
1501:SMAX2
1496:SMAX1
1476:only:
1449:only:
1353:Other
1275:Other
1187:Focal
820:Brain
723:Brain
658:10826
197:High
1177:and
888:PKAN
883:NBIA
642:MeSH
631:9-CM
590:PMID
541:PMID
492:PMID
453:PMID
416:2024
385:PMID
280:and
252:and
55:and
1491:SMA
1474:LMN
1447:UMN
1438:MND
1304:CSF
1255:TIA
900:PSP
876:NMS
845:and
706:CNS
627:ICD
580:PMC
572:doi
531:PMC
523:doi
484:doi
443:PMC
375:PMC
367:doi
1606::
1415:SA
922:OA
917:HD
866:PD
656::
645::
634::
588:.
578:.
568:52
566:.
562:.
539:.
529:.
519:75
517:.
513:.
490:.
480:20
478:.
466:^
451:.
439:16
437:.
433:.
406:.
383:.
373:.
363:12
361:.
357:.
332:.
272:,
78:.
1067:/
822:/
693:e
686:t
679:v
629:-
619:D
596:.
574::
547:.
525::
498:.
486::
461:]
459:.
418:.
391:.
369::
342:.
305:.
20:.
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