Pseudo Bulbar Palsy??

I just wanted to share this with you. Bob, my husband was diagnosed by his neurologist at the movement disorder clinic in Calgary. She made the diagnosis of PSP, and sent the information to the GP here. Every visit to the GP, he was calling this pseudo bulbar palsy, not progressive supra nuclear palsy. There is always so much going on at these appointments, I never had the opportunity to question why. With the internet, I searched pseudo bulbar palsy, and found it is indeed a 'group of symptoms', that is common in several neurological disorders. If I remember correctly, they had listed ALS, MSA, MS, PSP, and some others. I'm assuming that those are the symptoms in which the GP has most concern. Not a real helpful bit of info, but I thought it may be of interest to some.:)

Joan

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  • Yes you are right. Some doctors use this term Pseudobulbar palsy (or effect) to describe the problems of swallowing, speech and inappropriate emotional outbursts like laughing and crying, that occur as just one component of PSP (and other related neurological conditions that you mentioned). It's a bit complex but the term means that the problems stem from upper motor neurons, rather than the lower motor neurons (in which case it is called bulbar palsy).

    My wife's geriatrician likes to use this term rather than say PSP and my own general surgeon specifically used it even after I had explained PSP fully to him.

    Perhaps others have an idea why they restrict PSP to this term!

    All the best to Bob and yourself as you work through all the issues of this awful condition. I'm sure you'll continue to be helped by those who write on this forum.

  • Thanks! :)

  • Hello Joan, I was very interested in your post and comments on diagnosis. In October 2010 the neurologist told us my husband has PSP. Last week we went to the same neurologist for my husband's 6 monthly check up. Yesterday we received a copy of the letter he wrote to our GP. It ended, ".... as his syndrome has evolved it has become increasingly evident that he almost certainly has PSP". I was interested in the, "almost certainly".

    Best wishes.

    Nanna B

  • Interesting. The two things that distinguish PSP, according to the neurological staff at University of Florida, are EARLY falls, and eye movment vertical (not horizontal). These seem to distinguish PSP from other disorders with many of the same symptoms. Does your family member have vertical gaze issues and/or did they have falls early on as an initial symptom?

    Jimbo

  • They did test the vertical gaze at the neurologist's, and that was part of what the diagnosis was based on.The falling was absolutely one of the first symptoms, and as others with PSP, he had been originally diagnosed with Parkinson's. I honestly don't know how much of a problem he has with his eyes.

  • hi i have PSP dxd dec 2010 and the falls /completely illegible handwriting/inability to loook downwards ro upwards easily / poor cpoordinaiton in doing zips nbuttons up /dry eyes cos not blinking enougheech problems and a little with swallowing etc etc (see my about me)

    all contributed to the diagnosis

    plus dyslexic typign (!)

    all fo which are v frustrating

    but i am still here and am pretty sure i have the slow sort fo PSP

    BUT my brain is going to research when i do die and hten they will know for sure

    lol Jill

    :-)

  • your input always makes me smile jillann! My husband is the same,balance is poor, can't read his writing, zippers and buttons are too difficult, dry eyes, can't understand his speech, chewing/swallowing. Just the other day, our teenage daughter found an AP for his phone for text to speech! it is very cool! helps a lot.

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