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Bulbar Weakness or Dysfunction

From Bramwell: Atlas of Clinical Medicine ALS with Bulbar involvement

• Myasthenia Gravis
• Myopathies
  • Inflammatory
    • Polymyositis
    • Inclusion Body Myositis: Females; Swallowing dysfunction
  • Oculopharyngeal Muscular Dystrophy
  • Thyroid disorders
  • Distal myopathy: Vocal cord & Pharyngeal
• Motor Neuron Disorders
  • ALS: Slow moving tongue with relatively preserved bulk
  • Isolated Pseudobulbar Palsy (older females)
  • Bulbo-Spinal Muscular Atrophy
    • Clinical: Weak, wasted tongue with normal speed of movement
    • X-linked type
    • Dominant type
  • Brown-Vialetto-van Laere
  • Fazio-Londe
  • Worster-Drought syndrome
  • AAA syndrome
  • Tetanus: Dysphagia
• Nerve
  • Cranial nerve disorders
  • Acute neuropathy with bulbar dysfunction
• Also see
  • Vocal cord disorders
  • Focal myopathy
  • Neuromuscular + Gastrointestinal disease
  • Hoarse voice
  • Cough

Vocal Cord Disorders

• Nerve
  • HMSN (CMT) IA: PMP-22 Point mutation
  • HMSN (CMT) ID: EGR2
  • HMSN 2A2 (MFN2)
  • HMSN (CMT) IIC: TRPV4
  • GDAP1
    • CMT 4A
    • Axonal CMT with hoarseness (CMT 2K)
  • Distal HMN VII: 2q14
  • Distal HMN + Vocal cord 2: Dynactin; 2p13; Dominant
    
  • Scapuloperoneal SMA syndrome: TRPV4; 12q24
  • Neuromyotonia (Isaacs)
  • HSN + Cough & GE reflux: 3p22
  • Recurrent laryngeal nerve lesion
• Other
  • Distal myopathy with Vocal cord & Pharyngeal dysfunction: MATR3
  • Hypothyroid
  • Myasthenia gravis
  • Williams-Beuren syndrome
  • Arnold-Chiari Malformation
• Laryngeal abductor paralysis
  • Ataxia with Laryngeal abductor paralysis & Motor neuropathy
  • Multiple system atrophy