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Pseudobulbar palsy is a neurological disease associated with a lesion among the motor neurons in the area of the brain responsible for regulating chewing, swallowing, and speaking. It is a form of high motor neuron disease, a term referencing the location of the lesion, and it is not curable. Some steps can be taken to manage it, but patients usually die within three to four years of diagnosis, typically as a result of a pneumonia infection. Supportive care can be provided to make the patient as comfortable as possible.
In patients with pseudobulbar palsy, the speech becomes increasingly slurred and the patient has trouble chewing and swallowing. Some patients also experience emotional dysregulation and may have mood changes and emotional outbursts. Over time, patients may need to be provided with nutrition through a feeding tube as they lose the ability to chew and swallow. Mechanical ventilation may be required as well.
This condition can be caused by a number of things. Strokes, infections, and tumors can all lead to lesions among the high motor neurons. Progressive neurological diseases like Parkinson's disease and amyotrophic lateral sclerosis have also been linked with pseudobulbar palsy. Medical imaging studies of the brain can reveal changes and provide information about the extent of the damage.
Management of pseudobulbar palsy may include physical therapy to help patients retain strength and control over their muscles for as long as possible, along with the development of alternative communication methods so patients can communicate if their speech becomes unintelligible. Sign language and communication boards may be used, and patients can also work with devices intended to generate speech mechanically. For infections, medications can be provided to kill infectious organisms and patients may be provided with supportive care like suction to keep the throat clear and reduce the risk of aspirating fluids.
Treatment of neurological conditions like pseudobulbar palsy is constantly undergoing refinements as doctors learn more about the brain and its processes. Patients diagnosed with this condition may want to seek advice from a specialist to get information on the latest options for managing the disease. It may be possible to enroll in an experimental study and get access to new treatments not yet available to members of the general public. Participation in studies can also provide patients with an opportunity to interact with other patients who have the disease and people may have supportive advice and information for fellow study participants.
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