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Pseudobulbar palsy: a clinical computed tomography study.

C Loeb1, C Gandolfo, C Caponnetto

  • 1Department of Neurology, University of Genova, Italy.

European Neurology
|January 1, 1990
PubMed
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Suprabulbar palsy, a cerebrovascular disease complication, presents in pure and striate forms. Microinfarctions are key in the striate form, with hypertension and diabetes as common risk factors.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Pathology

Background:

  • Suprabulbar palsy is a neurological deficit resulting from cerebrovascular disease.
  • Understanding its subtypes and underlying pathology is crucial for effective management.

Purpose of the Study:

  • To characterize the clinical features, etiology, and risk factors of pure and striate forms of suprabulbar palsy.
  • To investigate the role of microinfarctions in the pathogenesis of striate suprabulbar palsy.

Main Methods:

  • Retrospective analysis of 61 patients with cerebrovascular disease exhibiting suprabulbar palsy.
  • Clinical assessment, neuroimaging (CT), and histopathological examination were utilized.
  • Risk factors including hypertension, diabetes, and dyslipidemia were recorded.

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Main Results:

  • The pure form (42 patients) presented with dysarthria, dysphagia, and automatic-voluntary facial dissociation. The striate form (19 patients) additionally showed rigidity and hypokinesia.
  • Multiple infarcts/lacunae were the primary cause of the pure form (85.7%).
  • Microinfarctions due to lipohyalinosis were identified as the leading pathogenetic factor in the striate form, with vascular lesions noted in 36.8% of CT scans.

Conclusions:

  • Pure and striate suprabulbar palsy have distinct clinical and etiological profiles.
  • Microinfarctions play a significant role in the pathogenesis of the striate form of suprabulbar palsy.
  • Hypertension, cardiopathy, smoking, dyslipidemia, and diabetes are prevalent risk factors for both forms.