BULBAR PARALYSIS. DISEASE OF MEDULLA OBLONGATA.
Impaired innervation of bulbar nerves. Paresis of lips, tongue, and larynx. Roaring. Rapid pulse. Glycosuria, albuminuria. Ptosis. Twitching eyelids. Dysphagia. Paralysis. Treatment, rest, cold to head, laxatives, nerve stimulants, tonics, electricity.
The bulb is intimately connected with the origin of the hypoglossal, glosso-pharyngeal, spinal accessory, vagus, facial, and trifacial nerves and active disease in the bulb is therefore likely to entail impairment of the function of several of these nerves. In man this is recognized in chronic progressive bulbar paralysis, which almost always affects the lips, tongue and larynx advancing steadily though slowly to a fatal termination. In degenerative lesions there is modified voice, difficulty of swallowing, rapid pulse, and laryngeal paralysis (especially of the arytenoid muscles). The implication of the root of the vagus may be inferred from the arrest of inhibition of the heart, and from glycosuria or albuminuria. Occasionally the ocular and palpebral muscles are involved causing ptosis, or twitching of the muscles. When the facial (7th) nerve is implicated, paralysis of one or both sides of the face may be marked, including often the ears. When the glosso-pharyngeal, the difficulty of swallowing is a prominent feature, and when the spinal accessory, spasm or paralysis of the neck. In the worst cases death supervenes early, by reason of interference with the respiratory and cardiac functions.
The treatment of these affections is usually very unsatisfactory, though in meat producing animals it may sometimes be desirable to preserve them in preparation for the butcher. Rest, in hyperæmic cases, cold to the head and purgatives, and in those in which fever is absent, small doses of nerve stimulants (strychnia) and tonics (phosphorus, phosphates, ammonia-sulphate of copper, zinc sulphate, silver nitrate) may be tried. A course of arsenic and carefully regulated electrical stimuli may at times give good results.