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What Is Progressive Bulbar Palsy?

By Sarah Sullins
Updated Mar 03, 2024
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Progressive bulbar palsy is a motor neuron disease (MND) that damages the nerve cells in the brain stem that supply the bulbar muscles -- those that control talking, swallowing, and chewing. Other areas of the body may also be affected by this disease.

The onset of this disease generally occurs in people between 50 and 70 years of age. When it develops in children, it is often referred to as infantile progressive bulbar palsy. The disorder is usually slow to start, but aggressive. Many times, a person who is diagnosed with this disease will only have a few years to live.

The main symptom of this condition is muscle weakness that causes difficulty chewing, talking, and swallowing. Weak jaws, throats, and facial muscles are also often reported, along with drooling and choking. A person with this disease may find that he can not move his tongue, making eating food difficult or impossible. Speaking usually also becomes hard, and eventually a person with this may not be able to speak at all.

Other symptoms, such as uncontrollable crying or laughing, may also occur. These are known as emotional lability and often happen with no warning, and for no reason. At times, progressive bulbar palsy can even affect a person’s arms or legs, making them weak. Sometimes, this loss of strength in the extremities is so subtle that it is not noticed right away.

Aspiration pneumonia is often the cause of death for those who have this aggressive motor neuron disorder. Inability to swallow properly or gagging can result in a person inhaling the food or drink he is consuming. When this occurs, the food or drink goes down into the lungs, increasing the chance of a person getting this pneumonia.

Treatment for progressive bulbar palsy is generally management of symptoms. Certain types of medications may be used to reduce muscle spasms and any pain associated with the degenerating muscles. Physical therapy is often recommended to keep muscles in action. In some cases, throat surgery may help an affected person be able to swallow. A nurse or qualified caregiver may be called in to assist a person with eating, if surgery is not an option or has failed to work. To help with changing emotions and depression that often occurs with progressive bulbar palsy, a patient’s doctor may prescribe an anti-depressant.

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Discussion Comments
By ggt246 — On Oct 13, 2015

So my soon to be 86 year old mother was diagnosed with progressive bulbar palsy the beginning of July. I have stayed off the internet due to the first article stated life expectancy to be 1-3 years. My mom is very active and still drives. I am seeing two totally different aspects in this blog. Two of which show me, though difficult, a "normal" life can be achieved, the other two posts do not portray this. I would appreciate any feedback that anyone of you can give me. Thank you in advance.

By anon292038 — On Sep 17, 2012

My father, who has been suffering from Pseudobulbar Palsy, has a remarkable temperament to face the disease. It has been almost six years when he was first diagnosed with the disease at the age of 78 years. He started doing yoga with a special focus on neck and throat exercises. He walks almost 1.5 km daily and does other yogic exercises.

By sheer determination, he has been eating semi solid diet and protein powders orally. To his dislike, he is getting a PEG fixed today in a hospital. He has an amazing temperament.

I have seen as a son that he had been communicating with me daily by writing on a piece of paper. I have learned a lot during this period. Knowing full well his problem, as well as the difficulties being faced progressively, I find him always cheerful and smiling. He still has full interest in life. He reads two or three newspapers, and watches sports and news channels. It is an amazing attitude and state of mind.

By anon277945 — On Jul 03, 2012

In the case of my husband who has had symptom onset for close to four years, he still works as a pistachio farmer from sun up to sun down, although he takes many more breaks in the day. He said he will rewrite the way this disease is described and I believe him.

By kylee07drg — On Jul 27, 2011

At the age of 55, my uncle got bitten by a tick infected with lyme disease. The doctors discovered it and treated him for the condition. However, recovery wasn’t so simple. The lyme disease led to the development of progressive bulbar palsy.

It was tragic that what we thought was a treatable condition morphed into something much more terrible. Just when he had hope for life, it got taken away again.

The doctor prescribed him an anti-depressant to help him cope with his incurable situation. I think it helped him make it through his last days. He knew that his life expectancy was about 14 months. However, he only lived 10 months more.

By Perdido — On Jul 26, 2011

When my grandfather found out he had progressive bulbar palsy, he immediately started getting his will and estate in order. His cousin had dealt with the same disease, and he died within two years of his diagnosis.

My grandfather started developing gag reflexes in response to the near constant drool that pervaded his throat. He had to be placed on a ventilator within a year.

After two years, he developed pneumonia. This ultimately is what killed him. I hated the fact that there was no cure and no specific treatment. I felt so helpless just standing by and watching him struggle.

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