CLINICAL FEATURES OF BULBAR AND PSEUDOBULBAR SYNDROMES IN CEREBROVASCULAR DISEASES
Keywords:
cerebrovascular diseases, stroke, bulbar syndrome, pseudobulbar syndrome, dysphagia, swallowing impairment, aspiration, aspiration pneumonia, dysarthria, dysphonia, oral automatism.Abstract
The article presents the clinical features of bulbar and pseudobulbar syndromes in patients with cerebrovascular diseases. The study was conducted in the Department of Resuscitation and Intensive Neurology of the 1st Clinic of Tashkent Medical Academy and included 40 patients with clinical signs of bulbar and pseudobulbar impairment. Of these, 22 patients had hemorrhagic or ischemic stroke involving the cerebral hemispheres, while 18 patients had brainstem stroke. All patients underwent clinical and paraclinical examinations on days 1–2 after hospitalization and were re-examined after 15–18 days. According to the results, swallowing impairment and choking while consuming liquid food were observed in 35 (87.5%) patients, dysarthria in 19 (47.5%), and fibrillary and fascicular movements of the tongue in 18 (45%) patients. Signs of pseudobulbar syndrome were identified in 22 (55%) patients, while bulbar syndrome was observed in 18 (45%). In patients with bulbar syndrome, tongue fasciculations, nasolalia, dysphonia, difficulty swallowing solid food, and decreased pharyngeal reflex were more frequently observed. Pseudobulbar syndrome was characterized by oral automatism reflexes, pathological laughing and crying, dysarthria, and swallowing impairment. The findings indicate the importance of early detection of bulbar and pseudobulbar disorders in stroke patients, timely assessment of dysphagia, and preventive measures to reduce the risk of aspiration and aspiration pneumonia.
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