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Clinical features of pseudobulbar palsy

Authoring team

The characteristic features of pseudobulbar palsy are:

  • apparent weakness of the muscles of mastication - V - and facial expression - VII - presenting with difficulty in chewing and an expressionless face. The jaw jerk is exaggerated.
  • spastic dysarthria - husky or gravelly voice
  • palatal weakness and difficulty in swallowing - X
  • brisk gag reflex - IX, X cranial nerves
  • tongue is immobile, pointed and cannot protrude - XII - this should be discriminated from the slow moving tongue seen in Parkinsonian patients
  • emotional lability - increased emotions with unprovoked outbursts of laughing or crying
  • bilateral limb upper motor neurone signs

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