clinical features of bulbar palsy

Last reviewed 01/2018

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