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Spastic dysarthria (Pseudobulbar palsy) - Coggle Diagram
Spastic dysarthria (Pseudobulbar palsy)
Lesion
UMN lesions-cerebral cortex, internal capsule, midbrain
Clinical signs
Spastic paralysis (Totally X move) /paresis (weak)
Little or no muscle atrophy
Hyperactive muscle reflexes
Pathological reflexes (positive Babinsky)-touch sole of foot for response
Cortico-bulbar lesion
Unilateral
Spastic weakness, contralateral lower half of face
Upper part STILL receives
__
Bilateral
Spastic weakness of both upper, lower face on both sides
Severe dysarthria
Direct Activation Pathways=pyramidal tracts
Cortico spinal tract- motor control of limbs
Cortico mesencephalic tract- motor supply extrinsic muscles of eye
Cortico bulbar tract: MOST IMPORTANT part of DAP for speech, terminate in LMN nuclei of all relevant cranial nerves: IMPT to consider, majority of fibres cross to contralateral side, some ipsilateral fibres
Persistent dyarthria is caused by
Bilateral disruption of UMN to bulbar cranial nerves
Spastic paralysis affecting bulbar musculature
Characterised by
Bilateral facial paralysis
Dysphagia, drooling
Bilateral hemiparesis- weakness of upper limbs
Incontinence
Emotional lability bcos of frontal lobe damage- eg uncontrollable laughter, crying
Hypophonia
Hyperactive jaw, sucking reflexes-DONT PUT FINGERS IN THEIR MOUTH