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["Psychogenic" bulbar paralysis].

T M Ettlin1, S Heim, U Steiger

  • 1Neurologische Universitätsklinik, Kantonsspital, Basel.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|November 24, 1992
PubMed
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This case study highlights a 58-year-old female with a 30-year history of swallowing difficulties. Neurological and neurophysiological studies ultimately diagnosed progressive bulbar palsy.

Area of Science:

  • Neurology
  • Gastroenterology

Background:

  • Persistent dysphagia (difficulty swallowing) over 30 years.
  • Previous investigations including barium-contrast radiography were inconclusive.
  • Surgical and psychological interventions proved ineffective.

Observation:

  • Swallowing difficulties exacerbated after a major depressive episode.
  • Patient also experienced mastication (chewing) problems and dysarthria (speech difficulties).
  • Symptoms indicated a potential neurological origin.

Findings:

  • Neurological examination revealed signs consistent with a motor neuron disorder.
  • Neurophysiological studies confirmed the diagnosis.
  • Progressive bulbar palsy was established as the final diagnosis.

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Implications:

  • Underscores the importance of comprehensive neurological assessment for chronic, unexplained swallowing disorders.
  • Highlights the potential for progressive bulbar palsy to present with long-standing, initially misdiagnosed symptoms.
  • Emphasizes the need for early and accurate diagnosis of motor neuron diseases for timely management.