Bulbarium syndrome. Pseudobulberry syndrome shortage of bulbar functions

Such a problem as the development of pseudobulbar syndrome in a child is a real test for parents. The fact is that the symptoms of this disease are manifested quite brightly and with a long reaction for a long time overcome.

What is a pseudobulberry syndrome

The essence of this disease is reduced to the appearance of multiple large and small hemorrhage foci, which lead to an amazing on both hemispheres of fibers connecting the motor cores of the brain cortex with a brain barrel.

This type of damage can develop due to repeated strokes. But there are cases where the pseudobulbar syndrome (PS) makes itself felt without preceding hemorrhage cases.

With such a problem, bulbar functions begin to suffer. We are talking about swallowing, chewing, articulation and lantern. Violation of such functions leads to such pathologies as dysphagia, dysphony, dysarthria. The main difference of this syndrome from the Bulbarin is that there is no development of muscle atrophy and reflexes are observed oral automatism:

Increased trunk reflex;

Reflex Openheim;

Nedolabial Reflex Actitzaturov;

Distant-aryal and other similar reflexes.

Pseudobulberry syndrome - reasons

The development of this syndrome is a consequence of atherosclerosis of the brain vessels and formed because of this softening foci, which can be localized in both hemispheres.

But this is not the only factor leading to such syndrome. The vascular form of the brain syphilis, as well as neuroinfection, degenerative processes, infections and tumors, affecting both hemispheres is capable of providing its negative impact.

In fact, the pseudobulberry syndrome occurs when against the background of any disease, the central roads are interrupted from the motor centers of the large hemispheres to the motor nuclei of the oblong brain.

Pathogenesis

The development of such syndrome is manifested by heavy atheromatosis of the arteries of the brain base, which affects both hemispheres. IN childhood The bilateral damage to the corticobulbar conductors, the consequence of which is cerebral paralysis.

If you have to deal with a pseudobulbar syndrome pyramidal form, then the tendon reflex increases. With an extrapyramidal form, slow motion, stiffness, anemia and an increase in muscle tone are first fixed. The mixed form involves the total manifestation of the signs described above, indicating the pseudobulberry syndrome. Photo of people affected by this syndrome confirm all the seriousness of the disease.

Symptoms

One of the main symptoms of this disease include a violation of swallowing and chewing. In such a state, the food begins to stick on the gums and for the teeth, the liquid food can flow through the nose, and the patient often accumulates during the meal. Moreover, changes occur and in voice - it acquires a new shade. The sound becomes hoarse, consonants fall out, and some intonations are lost at all. Sometimes patients lose the ability to talk with a whisper.

With such a problem as a pseudobulbar syndrome, symptoms can be expressed and by means of a bilateral pan of facial muscles. This means that the person acquires a masca anemic appearance. There is also a manifestation of attacks of violent convulsive laughter or crying. But such symptoms is not always present.

It is worth mentioning about the tendon reflex of the lower jaw, which in the process of development of the syndrome can increase dramatically.

Often the pseudobulberry syndrome is fixed in parallel with a disease such as hemiparesis. Perhaps the manifestation of extrapyramidal syndrome, which leads to stiffness, increase the tone of muscles and slow motion. Intellect disorders that can be explained by the presence of multiple softening foci in the brain are not excluded.

At the same time, in contrast to the bulbar, this syndrome eliminates the appearance of cardiovascular and respiratory disorders. This is explained by the fact that pathological processes do not affect the vital centers, but develop in the area of \u200b\u200bthe oblong brain.

Syndrome itself can have both a gradual start and acute development. But if we consider the most common indicators, it can be argued that in the overwhelming majority of cases, the appearance of pseudobulbar syndrome is preceded by two or more attacks of the violation of the cerebral circulation.

Diagnostics

To determine the pseudobulbar syndrome in children, it is necessary to differentiate its symptoms from jade, Parkinsonism, bulbar paralysis and nerves. One of the distinguishing features of the pseudorm will be the absence of atrophy.

It is worth noting that in some cases it is enough difficult to distinguish the PS from Parkinson-like paralysis. Such a disease occurs slowly, and at the later stages, apoplestic strokes are recorded. Moreover, similar to the syndrome signs are manifested: violent crying, a speech disorder, etc. Therefore, a qualified doctor must determine the patient's condition.

Development of syndrome in children

Such a problem, as a pseudobulberry syndrome, in newborns can manifest quite brightly. In the first month of life, signs of such a disease are becoming noticeable.

When examining a baby with pseudobulbar syndrome, fibrillations and atrophy are detected, but the reflex of oral automatism is recorded. Also, such a syndrome can lead to the appearance of pathological crying and laughter.

Sometimes doctors diagnose combined forms of pseudobulbar and bulbar syndrome. Such a form of the disease is a consequence of lateral amyotrophic sclerosis, thrombosis in the system of vertebral-basilar arteries, inoperable malignant tumors trunk or demyelinizing processes.

Treatment of syndrome

In order to influence the pseudobulberry syndrome in children, it is necessary to initially take into account the stage of its flow. In any case, the treatment will be the more effective than before the parents will behave to the doctor.

In the event that this syndrome progresses, funds that are focused on the normalization of lipid metabolism, coagulation processes and reduced cholesterol content in the blood are used. We can not be drugs that improve microcirculation, bioenergy of neurons and metabolic processes in the brain.

Such an impact is provided by such drugs such as "encephibol", "aminalon", "cerebrolysis", etc. In some cases, doctors may prescribe funds having an anticholinesterase effect ("Prezero", "Oxazil").

Considering which violations causes pseudobulberry syndrome in children, signs that testify to its development, it is extremely important to know. After all, if you ignore the obvious symptoms and do not start the treatment process on time, then completely neutralize the disease may not work. This means that the child the rest of his life will suffer from violations of the swallowing function, and not only.

But if you react in a timely manner, the chances of recovery will be quite high. Especially if stem cells are used in the treatment process. Their introduction with such a disease, as a pseudobulberry syndrome, can make the effect of physical substitution of myelin shell and, moreover, restore cell functions that were damaged. A similar recovery effect is able to return the patient to full-fledged life.

How to influence the state of only born children

If a pseudobulberry syndrome has been diagnosed with newborns, treatment will imply a complex approach. First of all, it is a massage of the circular muscle of the mouth, feeding through the probe and electrophoresis with the prozero on cervical spine.

Speaking about the first signs of recovery, it is worth noting that they include the appearance of the reflexes of the newborn, which were previously absent, stabilization of neurological status and positive shifts in fixed early deviations. Also, during successful treatment, there should be an increase in motor activity against the background of hypodynamine or the increase in muscle tone in the case of pronounced hypotension. In children having a large period of gestation, a meaningful reaction to contact and emotional tone is improved.

Recovery period in the treatment of newborns

In most cases, if you do not have to deal with non-develop heavy lesions, the early recovery period begins within the first 2-3 weeks of the child's life. When it is necessary to deal with such a problem as a pseudobulberry syndrome, treatment for 4 weeks and further includes the treatment of the recovery period.

At the same time, for children who had to postpone convulsions, drugs are selected more carefully. It is often used "Cortexin", the course of treatment of which is 10 injections. In addition to these measures during treatment, children are orally introduced "Pantogam" and "Nootropyl".

Massage and physiotherapy

Touching the use of massage, it is worth noting that it has preferably tonic and in rare cases relaxing effect. It is also held by all kids. The newborn, which have the spasticity of the limbs, the massage is shown earlier - on the 10th day of life. But it is important not to exceed the current norm - 15 sessions. At the same time, this method of treatment is combined with the adoption of Middokalm (twice a day).

Physiotherapy, in turn, is focused on carrying magnesium sulfate electrophoresis with aloe or lidase on the cervical spine.

Pseudobulbar disarth

This is one of the diseases that are a consequence of pseudobulbar syndrome. Its essence comes down to disruption of paths connecting the core of the bulbar group with cerebral bark.

This disease may have three degrees:

- Easy. There are insignificant violations and manifest in that children do badly argue growling and hissing sounds. While writing the text, the child sometimes confuses letters.

- Average. It is more common. In this case, there is actually complete absence of mimic movements. Children are difficult to chew and swallow food. The language also moves badly. In this state, the child can not clearly talk.

- Heavy degree (Anarteria). Mimic movements are absent completely, as well as the mobility of the muscles of the speech apparatus. Such children will unscrew the lower jaw, and the language remains fixed.

With such a disease, drug treatment, massage and reflexology techniques are used.

It is easy to conclude that this syndrome is enough serious threat The health of the child, so the disease requires a rapid response to the symptoms and patience in the treatment process.

There are many neurological diseases, but some of them are especially dangerous and difficult to cure. Among them, bulbaric syndrome is distinguished, in which patients have difficulties even with independent meals. It is very important to respond in a timely manner to the appearance of anxiety symptoms, as the delay in this case can lead to serious complications.

What is bulbary syndrome

Bulbarium paralysis is a serious secondary disease, which is associated with the damage to certain brain structures. In patients there is a deviation in the work of the nuclei and the roots of the bulbar group of the cranial brain nerves. Each of them has their own special and very important features that begin to gradually decline and even completely disappear:

Due to the defeat of these muscle groups, patients are gradually developing swallowing, speech pronunciation, and belligentness and hoarseness. Also suffer from various vital functions. Since the bulbar paralysis is a secondary disease, all patients have serious diseases, such as stroke, brain tumor formations, encephalitis and many others.

This disease has several synonyms: Bulbarium paralysis, bulbar paresis, bulbar disorders syndrome.

Video about bulbar paralysis and ways to treat

The difference between pathology from pseudobulbar paralysis

There is a similar difference in the name - pseudobulberry syndrome, which has several special differences.

1. Pseudobulbar syndrome It does not arise because of violations in the work of the oblong brain, and due to deviations in the conductivity of cortical nuclear paths.
2. Disease arises against the background of pathologies such as vasculitis, hypertensive brain infarction, peak disease, Parkinson ,.
3. In the language there are no atrophic changes.
4. Sometimes hemiparex develops, in which the muscles are paralyzed from one side of the body.
5. Atrophy of the facial and gentle muscles does not occur, there are no twisting of individual muscle fibers.
6. Patients have a trunk reflex, or oral automatism. If you knock on the mouth or nose next to your mouth, then the patient pulls the lips with a tube.
7. Patients appear violent crying and laughter due to spasms mimic muscles.
8. Facial muscles are paralyzed uniformly.
9. Female outcomes due to stopping respiratory and disruption of cardio-vascular system No missing.

Trump, or oral, reflex is characteristic distinctive feature Pseudobulbar syndrome

Causes and factors of development

The defeat of the cores of bulbar nerves occurs due to various diseases that lead to a violation of the work of the central nervous system. Most often, with the appearance of bulbar syndrome, the following primary pathologies are found in patients:

• stem stroke, as a result of which the oblong brain will be affected;
• infectious brain lesions due to tick-borne borreliosis, polyradiculoneuritis;
• tumor formation of the brain barrel;
• botoululus poisoning;
• brain damage against neurosimifilis;
• multiple sclerosis;
• fractures of the base of the skull;
• injuries that led to the displacement of brain departments;
• perverted blood formation (porphyria);
• bulbospinal Amiotrophy Kennedy;
• siringomily;
• motor neuron disease.

Also a frequent reason is hypertonic diseasewhich gradually worsens the patient's health. The developed atherosclerosis and spasm of vessels leads to brain ischemia, which contributes to the appearance of bulbar syndrome. In rare cases, the primary disease can be a kiaari anomaly, the basis of which is a violation anatomical structure and the location of the cerebellum and the oblong brain.

Causes of Bulbar Syndrome - Photo Gallery

Stroke - the most frequent cause Bulbaric syndrome The core of the bulbar group can be damaged by a tumor Fractures of the base of the skull contribute to the damage to the brain Progressive diseases of the nervous system - the cause of bulbar syndrome
The action of toxins negatively affects the work of the brain

Symptoms, including motor disorders

There are several types of bulbar paralysis:

1. A sharp usually appears due to a rapidly developing primary disease, such as stroke, encephalitis, brain edema, or in serious skull injuries.
2. The progressive develops gradually and is most often associated with various diseases of the central nervous system, such as Kennedy amiatrophy, neurosophilis, brain tumors.

Also, the bulbard syndrome can be one-sided and bilateral.

Basically, the disease affects the motor activity of the muscles of the pharynx, larynx and language, as a result of which three main symptoms are distinguished, which are characteristic of the bulbar paralysis:

The patients have a facial expression, the facial expression becomes inexpressive. The mouth of the patient is ajar, there is a salivament, the foggy falls falls out. However, themselves dangerous symptoms It is a violation of the respiratory function and the operation of the cardiovascular system, which can lead to a fatal outcome. These heavy manifestations appear due to the defeat of the wandering nerve.

When examining the oral cavity, changes in the appearance of the language are revealed, it becomes folded, uneven and periodically arbitrarily entered. If the patient has one-sided bulbar paralysis, then the soft palate saves only on the one hand, the language also changes only in a certain area and when pulling it out of his mouth, it is twisted towards the lesion. In the case of a bilateral impairment, a complete immobility of the language is called, which is called the glossale.

Because of the lesion of the sublard nerve, work is broken salivary gloysMany patients begin to suffer from hypersion. When combined with disturbed swallowing, this often becomes the cause of salivation. In some patients, this symptom is so strongly expressed that they constantly have to use the handkerchief.

Tongue muscle atrophy - typical sign of bulbar syndrome

Diagnostics

At the first signs of the bulbar paralysis should turn to a neurologist. During primary inspection The doctor will check the speed and vicinity of the pronunciation of words, the voice of the voice, the volume of salivation, will also explore appearance Language and presence of swallowing reflex. It is very important to estimate the frequency of respiration and heart abbreviations. With the help of a laryngoscope, it is possible to determine how much the closure of voice ligaments occurred.

To identify the primary disease, there may be a passage of various additional diagnostic methods:

With the help of magnetic resonance imaging of the brain, you can reveal tumors and other deviations

Additional research is also appointed:

• general analysis blood;
• general urine analysis;
• research of the spinal fluid.

Thanks to CT and MRI, you can identify various violations in the structure of the brain, as well as to detect tumors, edema, cysts and hemorrhage foci.

Differential diagnosis is carried out in order to exclude pseudobulbar paralysis, psychogenic dysfagia and dysphony, different kinds Mopaths, in which the paralysis of the muscles of the larynx and pharynx (miasthenia, oculoparing and paraxismal myopathy occurs).

Treatment

Since the bulbary syndrome is usually a secondary disease, then it is necessary to eliminate primary pathology. Unfortunately, most of them are incurable and progress throughout life. As patients, paralysis and gradual restoration of muscle work will be observed in patients. A very important task that is placed in front of doctors is the preservation of the patient all the functions of the body. With heavy forms of bulbar syndrome, patient may need artificial ventilation of lungs.

Patients with bulbar paralysis need help of loved ones, as they can have many difficulties with both having food and social life. It is very important to be next to the sick while eating to help him, if suddenly an aspiration occurs.

Medical therapy

There are many pharmacological preparations that can be prescribed in bulbar paralysis:

1. Synthetic cholinesterase inhibitors are necessary to restore muscle operation (prozerne). The swallowing reflex, the stomach motor is improved, the blood pressure is reduced and the pulse is penetrated.
2. M-cholinoreceptor blockers are needed with abundant and uncontrollable saliva (atropine).
3. Various antibiotics are needed in the treatment of infectious infection.
4. Non-voice diuretic drugs are necessary in the enemy of the brain (Furosemid, Toramsemid).
5. Vasoactive drugs are necessary in the presence of vascular disorders (Parmidin, Alpostan).
6. Group Vitamins are needed to maintain and restore the nervous system (neuromulitivitis, Milgamma, Vitagamma).
7. Preparations with glutamic acid stimulate metabolic processes in the central nervous system.

Preparations for the treatment of bulbar syndrome - Photo Gallery

Prezero improves muscle performance
Atropine eliminates saliva Furosemide is used to remove the brain edema Milgamma normalizes the work of the brain Ceftriaxone - antibiotic wide spectrum Actions for the treatment of infections

Features of nutrition

When running stages, when it becomes an impossible patient to take food on its own, power is assigned through the tube. The patient establishes a special nasogastric or a gastric food probe, according to which various balanced mixtures come. It is necessary to take into account the medical personnel to independently carry out this procedure at home.

With the help of a doctor, you need to choose a special diet that will provide a patient with a balanced nutrition to support health and speed up the recovery process. The food is administered only in liquid form, no lumps are allowed or solid elements. Special preparations are usually used that have a homogeneous structure and easily pass through the tube. One of these means is the nutrison, which is produced in both the finished drink format and in the powder. It includes the required amount of proteins, fats and carbohydrates, as well as trace elements and vitamins.

Nutrison - finished nutritional mixture for probe food

After feeding the tube can be left for about five days, then it is necessary to replace it or thoroughly and disinfected. The syringes themselves for the introduction of food is required to clean each time after eating.

Video about enteral feeding using a nasogastric probe

Physiotherapeutic methods

Patients need to attend the treatment massage sessions, where they will help develop muscles and speed up the process of recovery. Initially, there is a study of the front surface of the neck. In the position of the lying, the patient massaging the mouse muscles in the course of lymphatic vessels. Also developed the inner surface of the mouth, the palate and language.

Patients with bulbar paralysis are prescribed by kinesotherapy - a variety medical gymnastics. Often combined with breathing exercisesTo speed up recovery and develop lungs. There are several certain exercises that are prescribed for bulbar paralysis. When they are fulfilled, the specialist helps the patient, passively shifting the hands of the muscles and the larynx in the right direction:

1. For stimulation of the gentle-pharyngeal muscles and swallowing muscles, patients make an exercise - putting on the lower jaw on the top and vice versa. In the sitting position it is necessary to slowly and deep breathe, push low jaw Forward and then with the strength of a jaw. After you need to exhale, return to the original position and maximize the lower jaw back, and the front to be covered. At the same time, patients occur nod to the nick, which stimulates the work of the muscles of the pharynx and larynx.
2. In the sitting position or standing, begin to press the chin as much as possible to the neck. On the breath, raise your head, in exhalation - lower.
3. In the idle position, squeeze the jaws with force, pull the corners of the mouth towards the ears and make swallowing movements.
4. In the idle position, start to tear your head from the pillow on the breath and slowly lower it on the exhale.

Video about therapeutic exercises in bulbar paralysis

Surgical intervention

Operational intervention is appointed with various diseases that cannot be cured by conservative way. With tumor formations sometimes shown them surgical removal. In the case of fractures, an operation can be assigned to eliminate the effects of injury and the restoration of the integrity of the skull.

Features in children, including newborns

In children, bulbar paralysis can often develop due to hypoxia or various injuries obtained during childbirth. Newborn babies in the first weeks of life doctors resort to restoration of reflexes. In addition to medicinesBabies need massage and physiotherapy procedures. However, not always these measures helps to improve the condition of the child, and primary disease quickly progresses. When examining a pediatrician often marks an increased humidity in the oral cavity, and during crying is visible to the tip of the tip. Sometimes parents notice the newborn disturbance of the facial expressions, the face becomes still, it cannot independently swallow the milk or the mixture.

For many children are becoming a need for classes with a speech therapist. Because of the atrophy of the muscles of the face and language, the child can break the speech, it becomes vague, which significantly worsens his social adaptation and learning ability.

Classes with speakers are extremely important for patients with bulbar syndrome.

Prediction of treatment and possible complications

The forecast of treatment with bulbar paralysis is very variable and strongly depends on what primary disease was detected in a patient. If it is possible to get rid of it in the shortest possible time, then all the functions of the body can also quickly recover. However, in severe cases, lethal outcomes are recorded due to respiratory and cardiovascular failure. The most unfavorable forecast for those patients who have been detected by a constantly progressive disease of the central nervous system.

Prevention

For the prevention of bulbar syndrome, it is necessary to carefully monitor its health and in a timely manner to treat all the diseases. It is also important to avoid injuries of the brain and void infectious pathologies. There are advice that help to avoid the emergence of many diseases in the future:

At various lesions of the brain, complexes of characteristic disorders called syndromes are developing. One of them is pseudobulbar paralysis. This state occurs when the cores of the oblong brain cease to receive sufficient regulation from the overlying centers. This does not represent the immediate danger to the patient's life, unlike the bulbar paralysis. Right differential diagnosis Between these two syndromes, not only allows the doctor to determine the level of lesion, but also helps to assess the forecast.

How does pseudobulberry syndrome occur

In the brain there are "old" departments that can work autonomously, without the regulatory effect of the bark. It supports life-intensiveness even in damage to the highest departments of the nervous system. But such basic neurons activities are accompanied by a violation of complex motor acts. After all, for agreed work different groups Muscles need clear coordination of various nerve impulses, which can not provide only subcortical structures.

Pseudobulberry syndrome (paralysis) occurs when violating the highest regulation of motor (motor) nervous nuclei in the oblong brain. These include centers 9, 10 and 12 pairs of cranopy brain nerves. Many paths in the brain have a partial or complete cross. Therefore, the complete disappearance of controlling pulses occurs when the bilateral defeat of the frontal departments of the brain cortex or with extensive damage to the subcortical nerve paths.

The kernel remaining without the "commander" begin to work autonomously. The following processes occur:

• the function of respiratory muscles and heart is preserved, that is, vital acts remain unchanged;
• articulation changes (pronunciation of sounds);
• because of the paralysis of the soft sky, swallowing is broken;
• there are involuntary stereotypical grimaces with imitation of emotional reactions;
• voice ligaments become low-lived, the lantern is disturbed;
• deep unconditional reflexes of oral automatism are activated, which can only be discovered in babies.

In the formation of such changes, the cores themselves of the oblong brain, the cerebellum, the brain barrel, the limbic system and the set of paths between the individual subcortical structures of the brain themselves take part. It is raised and discooring work.

The difference of the bulbar syndrome from pseudobulbar

Bulbarium syndrome is a complex of disorders arising from damage to the nuclei itself in the oblong brain. These centers are located in the thickening of the brain, called the boulevard, which gave the name to the syndrome. And with pseudobulbar palsy, the kernel continue to function, although coordination between them and other nervous formations is disturbed.

In both cases, articulation, lantern and swallowing suffer. But the mechanism for the development of these violations is different. With a bulbar syndrome, a pronounced peripheral paralysis of the muscles of the pharynx and a soft sky with the degeneration of the muscles themselves, often accompanied by a violation of vital functions. And with pseudobulbar syndrome, paralysis is central, the muscles remain unchanged.

Causes of pseudobulbar syndrome

Atherosclerosis can lead to the damage to neurons in the cerebral cortex and, as a result, to pseudobulbar syndrome.

The pseudobulberry syndrome is a consequence of damage to neurons in the frontal part of the cerebral cortex or nerve paths coming from these cells to the cores in the oblong brain. The following states can lead to this:

• hypertensive disease with the formation of multiple small or, repeated strokes;
• atherosclerosis of small brain vessels;
• one-sided lesion in the brain of the arteries of the middle and small caliber, which leads to the condemnation syndrome (blood supply deficiency) in symmetric areas;
• vasculitis with systemic red lolly, tuberculosis, syphilis, rheumatism;
• degenerative diseases (, peak disease, supranklear paralysis, and others);
• effects ;
• the effects of brain damage to intrauterine or as a result of generic injury;
• the consequences of pronounced ischemia after clinical death and comatose states;
• pronounced metabolic disorders on the background of the long use of valproic acid preparations;
• tumors of frontal fractions or subcortical structures;

Most often, the pseudobulberry syndrome occurs in chronic progressive states, but it may appear in acute oxygen starvation of many brain departments.

Clinical picture

Such patients can laugh or cry against their own will.

The pseudobulberry syndrome is characterized by a combination of swallowing, speech, advent of violent grimace (laughter and crying) and symptoms of oral automatism.

The appearance of camping and pauses before starting swallowing is explained by the paresis (weakness) of the muscles of the pharynx and the soft sky. In this case, the violations are symmetrical and not so coarse, as with bulbar paralysis. Neither atrophy, no twitching muscles appear. A silent reflex is even elevated.

Violations of speech in pseudobulbar syndrome capture only pronunciation - it becomes fuzzy and as if lubricated. This is called dysarthria, it can be caused by paralysis or spastic muscle tone. In addition, the voice becomes deaf. This feature is called dysphony.

The syndrome necessarily includes symptoms of oral automatism. Moreover, the patient himself does not notice them, these signs are detected when conducting special tests during a neurological inspection. Easy irritation of some zones leads to a reduction in chin or near-theft muscles. These movements resemble sucking or kiss. For example, such a reaction appears after touching the palm or angle of the mouth, when tapping on the back of the nose. And with a slight impact on the chin, chewing muscles are reduced, closing a lingered mouth.

Often there are violent laughter and crying. This is called characteristic short-term reductions in mimic muscles, similar to emotional reactions. These involuntary grimaces are not associated with any impressions and cannot be stopped by the effort of will. Arbitrary movements of the face muscles are disturbed, because of what a person can open his mouth at a request to sculpt his eyes.

Pseudobulberry syndrome is not isolated, it appears against the background of others neurological violations. The overall picture depends on the root cause. For example, the defeat of the frontal fractions is usually accompanied by emotional-volitional disorders. This man may become a low-effective, misintermetative or, on the contrary, defused in his desires. Dysterry is often combined with reduced memory and speech disorders (aphasia). With damage to the subcortex zones, various motor disorders often occur.

How to treat

When identifying pseudobulbar syndrome, the main disease must first be treated. If it is hypertensive, prescribe hypotensive and vascular therapy. With specific vasculitis (syphilitic, tuberculosis), antimicrobial agents are used, antibiotics. At the same time, treatment can be carried out in conjunction with narrow specialists - dermatovenerologist or phthisiators.

In addition to specialized therapy, drugs are prescribed to improve microcirculation in the brain, normalizing the operation of nerve cells and improving the transfer of nerve pulses. For this purpose, various vascular, metabolic and nootropic agents, anticholinesterase drugs are used.

There is no universal means for the treatment of pseudobulbar syndrome. The doctor picks up a schema complex therapy Taking into account all the disorders. At the same time, special exercises for affected muscles can be used in addition to the admission of medicines, a respiratory gymnast for stalenitor, physiotherapy. If there is a violation of speech in children, classes with a speech therapist are defined, this will significantly improve the adaptation of the child in society.

Unfortunately, it is usually not possible to completely get rid of pseudobulbar syndrome, because such violations occur with the pronounced bilateral lesions of the brain, which are often accompanied by the death of many neurons and the destruction of nervous paths. But the treatment will allow to compensate for violations, and rehabilitation classes will help to adapt to the problems arising. Therefore, you should not neglect the recommendations of the doctor, because it is important to slow down the progression of the underlying disease and preserve the nerve cells.

Bulbarium syndrome is a serious neurological disease. Pathology leads to paralysis of the tongue, the muscles of the pharynx, lips. Progressive Bulbarium Paralycia is hazardous to human health and is seriously treated.

The patient can feel like he has difficulties with independent eating. It will be necessary to visit medical institutionAs soon as the first symptoms appear.

If you ignore the signs, then there will be irreversible consequences. Bulbarium syndrome dangerous illness and it must be treated in a timely manner.

Bulbar nerves are affected due to the development of neurology. This leads to changes in the central nervous system. When the motor's nerve endings are affected, peripheral paralysis occurs.

Observed the following reasons Bulbaric syndrome:

• , because of which the oblongable brain will be affected;
• infectious diseases of the head;
• malignant and benign tumor processes;
• bruises and fractures of the base of the cranial box;
• inflammation in the brain;
• inxication of botulinumsin.

It often happens that hypertension becomes the cause of the bulbar paralysis. Disease over time worsens the patient's condition. Against the background of this, atherosclerosis develops, vascular spasm occurs, and this leads to a stroke, so the bulbaric syndrome occurs.

If observed bad state of health, then you need to contact the doctor. If you ignore the bulbar symptoms, there may be various complications.

Symptoms

There are several types of bulbar syndrome. Acute form of pathologists is moving speed and develops against the background of stroke, edema or brain ears, encephalitis. If a disease of a progressive nature, a bulbar paralysis arises slowly.

It happens against the background of various pathologies that are associated with the central nervous system. Most often it is amiatrophy of Kennedy, tumor education in the brain. Bulbarium syndrome is bilateral and one-sided. Pathology is often reflected on the movements of the larynx, language, pharynx.

There are three signs that are manifested in bulbar paralysis:

• Dysphagia - It's when swallowing. The patient with difficulty is to swallow the food due to the fact that it progresses the paralysis of the soft sky. A weak patient can easily become food. Over time, progressive bulbary paralysis develops, and the patient with difficulty can even use a soft food.
• Dysarthria. There is a violation of the pronunciation of words. At the beginning of the patient, there may be sounds, but the bulbar paralolines leads to a complete absence of speech.
• Dysphony leads to violation of voice functions. A person watches, as his arise, hoarseness.

In a patient, a mimic and facial expression may be affected with a bulbar paralysis. The mouth can be opened, saliva will stand out. When receiving food, food can fall out of the mouth. Bulbarium syndrome can lead to serious consequences in the form of disturbances of the respiratory and cardiovascular system.

The patient has changes in the oral cavity. Language becomes uneven, folded and at times twisted. If the patient has unilateral bulborous syndrome, then the changes will be on the one hand. When bilateral defeat, the language can be completely immobile.

When changes are occurred by the approximate nervous end, it begins to highlight saliva. Many patients may suffer a strong salivation, so they use a handkerchief on an permanent basis. At the first manifestations of the bulbar syndrome, you need to visit a specialist.

Diagnostics

Appoints the diagnosis and treatment of bulbar paralysis neuropathologist. First of all, a specialist conducts a neurological examination and electromyography. According to the results of diagnosis, the doctor reveals the cause of the bulbar syndrome and prescribes treatment. The specialist should determine the frequency of breathing and heartbeat.

The following studies are carried out in bulbar paralymps:

• Radiography makes it possible to reveal fractures and bruises of the head, tumor processes.

• Electromyography helps to check the performance of the muscles of the tongue, neck, hands, legs. This type of diagnosis reveals muscle activity in a calm state and with a reduction.
• Ezophagoscopy. Such a research method helps to examine the esophagus. The performance of the muscles and voice ligaments is estimated.

• Magnetic resonance imaging. Fast and high-quality diagnostic method, identifies various diseases in 90% of cases. MRI makes it possible to assess the condition of all organs. Tomography helps to identify brain pathology. The study is most often carried out using a contrast agent.
• Electrocardiogram. Gives the opportunity to find different diseases Hearts, study heart rhythm.

• Laboratory studies are conducted in order to reveal inflammatory processes, infection, hemorrhage. A general analysis of urine, blood and examination of the spinal fluid is prescribed.

When conducting computer tomography and MRI, detected in the brain tumor education, edema, cysts. If the first symptoms of the bulbar paralysis appeared, then the doctor must be immediately visited. The disease over time is only progressing, without treatment can not do. The disease can lead to a fatal outcome.

Bulbarium paralysis in children

Bulbarium paralysis develops from innocent children. There is a strong humidity of the mucous membrane, it should be in the normal state almost dry. If you inspect the oral cavity of the child when it cries, then you can see that the language is slightly turned to the side. This feature Appears with a violation of the sublard nervous end.

Bulbaric syndrome in children is manifested in rare cases, since it occurs with the brain stems. They cease to function, and life without them is impossible. Children often occurs pseudobulbar paralysis, it passes extremely difficult. The kid suffers not only from speech loss, but also from changes in the muscular tone.

Hypercines and various disorders of the propeller can also develop. This leads to the fact that children's cerebral paralysis. The disease may begin to disturb the newborn and children to a two-year-old age. Most often, cerebral palsy arises due to generic injuries.

In case of bulbar syndrome, a child has a violation of motility. It happens that there is a defeat of the upper facial part, because of this, immobility arises. The child does not have the opportunity to care for himself. Such children look awkwardly, they are hard to chew and swallow food, keep saliva in the oral cavity. Must be appointed proper treatment With bulbar paralysis.

Treatment

If in the patient acute form Bulbar paralic, it should be provided in a timely manner health care. Therapy will be aimed at eliminating the complications of pathology. First of all, the patient is connected to the machine of artificial ventilation of the lungs. It is necessary in order to maintain the viability of the patient and restore the breath with the bulbar syndrome.

Prezero, adenosine trophosphate, vitamins, they help activate swallowing reflexes, improve the stomach motor. Using the regulation of swallowing, the production of gastric juice is reduced, saliva. The patient makes a dropper with atropine. The drug is produced by B. various formsBut, since the patient has a violation of swallowing reflex, the medicine is administered intravenously.

Eating through the probe. This feeding method makes it possible to avoid hitting food into the respiratory system. If a person is in comatose state, he is injected with a dropper nutrient elements and glucose. Patients suffering with bulbar paralysis, sensitive, irritable, depressive.

It happens that many patients may refuse meals, as it is afraid to be sought. Such patients are sent for treatment to a psychotherapist. Appointed also medical therapy With bulbar syndrome.

Medications

The following drug preparations are used to treat pathology:

• Prezero is prescribed to restore muscle performance. Helps improve swallowing functions, stomach motor. If there is an increased blood pressure, then the drug reduces it.
• Atropine is used with a strong salivation.
• Antibiotics are prescribed if there are infectious diseases.
• ToramSemid, Furosemid are antietal diuretic drugs, are needed in order to remove swelling in the head.
• Parmidine, Alpostan, are applied at various diseases vascular system.
• Vitamins B, neuromulitivit, Milgamma, Vitagamma, they are assigned to support and restore the CNS.
• Funds with glutamic acid improve exchange Process In the nervous system.

Use all medicines is necessary after the doctor will appoint them. Some drugs have a number of contraindications and side effects. It is not recommended to engage in self-medication, as it is possible only to worsen the condition of the patient with a bourgear paralysis. It is necessary to present special nutrition, since with a neglected disease, the patient cannot use food independently.

The patient is only powered through a nasogastric or a gastric food probe, through it a special mixture. The doctor should show how to properly feed the patient at home with a bourgear paralysis. Specialist picks up required rationTo ensure the patient with all the necessary vitamins for speedy recovery.

Food is given liquid, without lumps and solid pieces. As a rule, items are used that have a homogeneous mass and easily pass along a special tube. The nutrone is produced as a powder and a finished drink. This preparation includes all the necessary proteins, fats, carbohydrates, vitamins, trace elements.

Patient feeding tube can be used for about five days. Next it is replaced or well is washed and processed. The syringes that are necessary for the introduction of food should be cleaned immediately after feeding.

Folk ways of treatment

Can be combined with medication therapy national Medicine. There are many recipes for the treatment of progressive bulbar paralysis. Drug collection is prepared on the basis of white mistletoe, Valerian's root, souls, yarrow. For the preparation of the tincture, all listed plants are taken in equal amounts, poured boiling water. It is necessary to use vegetable tool three times a day at a hundred grams before meals.

• The next recipe is prepared from mint, souls, mistletoes, mother-in-law, thyme, melissa. You need to mix all together and pour hot water. Wait until cool and strain content. The means for the treatment of bulbar paralysis inside a hundred grams after meals.
• Alcohol tincture based on the root of peony. To prepare, rub the plant on the grater and pour alcohol one to ten. Put the tincture in a warm place for seven days as soon as it is ready, strain it. It is necessary to take 35 drops three times a day before eating.

• In order to make a tincture of sage, a plant is taken and poured boiling water. Put in a warm place for eight hours. Strain and use on a tablespoon several times a day after meals. You can take therapeutic baths from sage and rose robes with bulbar syndrome. About 300 grams of the plant takes, poured with water and puts it for 15 minutes. Let break about an hour, strain the remedy and pour into the bath. The procedure should last at least thirty minutes. In order to achieve the effect in the treatment of bulbar paralysis, you need to take a bath a couple of times a week.

• It is necessary to take the fresh leaves of the Sumy Tubin and pour hot water. Put in a warm place for an hour and strain the remedy. You need to eat about three times a day on a tablespoon. If correctly use folk ways Treatment, it will help reduce bulbarium paralysis. Before use, you need to consult with your doctor.

Progressive bulbary paralysis carries a greater danger if it is not treated. At first symptoms, you need to contact the medical institution. The neuropathologist will inspect and prescribe a comprehensive diagnosis.

Bulbarbage syndrome refers to the pathology of the cranial nerves, when not a single nerve is affected, and a whole group: languagehift, wandering and subwage, whose kernels are located in the oblong brain.

Symptoms and causes of bulbar syndrome

Bulbarium syndrome (otherwise - Bulbarium paralysis) is one or bilateral. Against the background of pathology, swallowing disorders often arise. This leads to the fact that it becomes difficult or impossible (Afgha). Also, usually against the background of the syndrome, there are arctications of speech and voices - it acquires a vile and hoarse shade.

A vegetative system disorders may also develop, manifest usually in the form of heart activities and respiration.

Most often signs of bulbar syndrome are:

• Lack of facial expansion, the inability to chew independently, swallow, close the mouth;
• Entering liquid food in the nasopharynk;
• Sweeting Soft Sky and the deviation of the tongue to the side opposite to the defeat of paralysis;
• Lack of sky and pharyngeal reflexes;
• Vague, vile speech;
• Disorders of the lantern;
• Cardiovascular disorders;
• Arrhythmia.

The main reasons for bulbar syndrome doctors include various diseases:

• Myopathy is an oculoparingeal, Kirsa-Seyon syndrome. The peculiarity of the hereditary disease of the equalphabetal myopathy, as one of the causes of the bulbar syndrome, is later the beginning (most often after 45 years), as well as muscle weakness, limiting the face muscles and bulbar muscles. The main disappointing syndrome is dysphagia;
• Motor neuron diseases - spinal amyotrophy of Fazio-Londa, lateral amiotrophic sclerosis, BULBOSPINAL AMIOTROFYA KENNED. In the beginning of the disease, it is difficult to swallowing more often with liquid food than solid. However, with the progression of the disease simultaneously with the weakness of the language, the weakness of the facial and chewing muscles is developing, and the language in the oral cavity becomes atrophig and still. There is a weakness of respiratory muscles and constant saliva;
• Dystrophic myotonia, which more often amazes men. The disease begins at 16-20 years. Bulbarium syndrome leads to dysphagia, a nasal shade of voice, defenders, and in some cases - to respiratory disorders;
• Paroxysmal misoplege, manifested by partial or generalized attacks of muscle weakness, which can continue from half an hour to several days. Provoke the development of the disease Increased consumption of cook salt, rich in carbohydrates abundant food, stress and negative emotions, elevated physical exercise. Respiratory muscles are rarely involved;
• Miasthenia, basic clinical manifestation which is excessive muscular fatigue. Its first symptoms usually there are violations of the functions of the glasses and muscles of face muscles and limbs. Frequently bulbary syndrome affects chewing muscles, as well as muscles of larynx, pharynx and language;
• Polyneuropathy, in which bulbarium paralysis is observed against the background of tetraplegia or tetraprack with quite characteristic disorders, allowing to facilitate the diagnosis and treatment of bulbar syndrome;
• Poliomyelitis, which is recognized by general-infectious symptoms, rapid development of paralysis (as a rule, in the first 5 days of the disease) with a significantly greater lesion of the proximal departments than distal;
• The processes occurring in the rear cranial fossa, the trunk of the brain and the cranium-spinal region, including tumor, vascular, granulomatous diseases and bone anomalies. Usually these processes involve two halves of the oblong brain;
• Psychogenic dysphony and dysphagia, which can accompany both psychotic disorders and conversion disorders.

Pseudobulbar syndrome

The pseudobulberry syndrome usually arises only against the background of bilateral damage to cortical nuclear paths, which go to the nerve nuclei of the bulbar group from motor cortical centers.

This pathology is manifested by central palsy of swallowing, disorders of the lantern and speech articulation. Also on the background of pseudobulbar syndrome may occur:

• Dysphagia;
• Dysarthria;
• Dysphonia.

However, unlike the bulbar syndrome, in these cases does not develop muscle atrophy. Also, palatal and sipboard reflexes are also preserved.

Pseudobulberry syndrome, as a rule, is observed against the background of discirculatory encephalopathy, acute violations of the brain circulation of both hemispheres of the brain, side amiotrophic sclerosis. It is considered less dangerous because it does not lead to violation of vital functions.

Diagnosis and treatment of bulbar syndrome

After consulting the therapist for the diagnosis of bulbar syndrome, it is usually necessary to pass a number of studies:

• General urine analysis;
• EMG muscle language, limbs and neck;
• General I. biochemical analysis blood;
• CT or MRI brain;
• Esophagoscopy;
• Inspection of the eyepiece;
• Clinical and EMG samples at miasthenia with pharmacological burden;
• Study of liquor;

Depending on the clinical symptoms and nature of the flow of pathology, the doctor can predict the outcome and effectiveness of the alleged treatment of bulbar syndrome. As a rule, therapy is aimed at eliminating the causes of the main disease. At the same time, measures are being held to support and resuscitate the disturbed important functions of the body, namely:

• Breathing - artificial ventilation of the lungs;
• Swallowing - drug therapy by prozero, vitamins, ATP;
• Slutage - appointment of atropine.

It is quite important on the background of pseudobulbar and bulbar syndrome to carry out careful care oral cavity, as well as, if necessary, watch the patients during meals to prevent aspiration.