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Bulbar Signs in Normal Population

Published online by Cambridge University Press:  02 December 2014

K S Lim*
Affiliation:
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia
Y C Hew
Affiliation:
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia
H K Lau
Affiliation:
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia
T S Lim
Affiliation:
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia
C T Tan
Affiliation:
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia
*
Neurology Laboratory, 5U, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia.
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Abstract

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Background and Objectives:

There is lack of published data on bulbar signs among the healthy population. This study aims to determine the range of normality of bulbar signs particularly among the elderly.

Methods:

Systemic examination of bulbar signs was carried out according to a predetermined protocol on a cohort of young and elderly healthy subjects.

Results:

A total of 206 subjects were recruited in the study, 104 young adults with mean age of 20 years, and 102 elderly with mean age of 73 years. Uvula deviation was seen in 28 (26.9%) young subjects and 22 (21.6%) elderly. Irregular tongue border was seen in 17 subjects, unilateral in 4 subjects. Fourteen (6.8%) subjects had deviation on tongue protrusion. Occasional tremor of tongue on protrusion is common in both young and old. Persistent (severe) tongue tremor on protrusion was seen in 18.6% of the elderly, and 4.8% of the young. None of the subjects had tremor of tongue at rest. In gag reflex, absence of gagging response was common in elderly, seen in two thirds of the subjects on stimulation of the posterior pharyngeal wall. However, all the subjects had uvular movement. Habituation or suppression of gagging response was seen in close to 90% of young males.

Conclusion:

There is wide range of normality in bulbar signs in normal population, particularly among the elderly.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Leder, SB.Gag reflex and dysphagia. Head Neck. 1996;18(2): 13841.Google Scholar
2.Davies, AD, Kidd, D, Stone, SP, MacMahon, J.Pharyngeal sensation and gag reflex in healthy subjects. Lancet. 1995;345(8948): 4878.CrossRefGoogle ScholarPubMed
3.Campbell, WW.Dejong’s the neurologic examination. 6th ed. United States of America, Philadelphia: Lippincott Williams & Wilkins; 2005. p. 273.Google Scholar
4.Anderson, DM.Dorland’s Illustrated Medical Discionary. 30th ed. Philadelphia: Saunders; 2003. p.676.Google Scholar
5.Talley, JN.Clinical examination: a systematic guide to physical diagnosis. 5th ed. Sydney: Churchill Livingstone; 2006.Google Scholar
6.Campbell, WW.Dejong’s the neurologic examination. 6th ed. United States of America: Lippincott Williams & Wilkins; 2005. p. 254.Google Scholar
7.Deuschl, G, Bain, P, Brin, M.Consensus statement of the movement disorder society on tremor. Ad hoc scientific committee. Mov Disord. 1998;13:223.Google Scholar
8.Louis, ED, Marder, K, Cote, L.Differences in the prevalence of essential tremor among elderly African Americans, whites, and Hispanics in northern Manhattan, NY. Arch Neurol. 1995;52: 12015.Google Scholar
9.Louis, ED, Ottman, R, Hauser, WA.How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord. 1998;13: 510.Google Scholar
10.Findley, LJ.Epidemiology and genetics of essential tremor. Neurology. 2000;54 Suppl 4:S813.Google Scholar
11.Elble, RJ.Diagnostic criteria for essential tremor and differential diagnosis. Neurology. 2000;54 Suppl 4:S26.Google ScholarPubMed
12.Lou, JS, Jankovic, J.Essential tremor: clinical correlates in 350 patients. Neurology. 1991;41:2348.CrossRefGoogle ScholarPubMed