Bulbar Lesion in Aging

Abstract

Although there are many important nerve centres in medulla oblongata, clinical detection for its lesions is very difficult. Since about 10 years, Mashiko, one of the author has done the electromyographic studies on tongue muscles. In the patients with bulbar lesions, findings of the lower motor neuron lesions were most frequently observed electromyographically. Now, the authors studied on the bulbar lesions in aging.
Results obtained were as follows:
1) Fifty-one cases with bulbar lesions were separated in 2 groups; that is, 40 cases as aging above 50 years old and 12 cases below it.
Comparative studies were done between these 2 groups.
a) Symptoms frequently appeared were in order to dysarthria, headache and swallowing disturbance. Dysarthria was seen in 80.4%.
b) In pathogenesis, vascular origins were very frequent in both groups. In aging, cerebral thrombosis was frequently observed associating hypertension and arteriosclerosis in retina.
c) Findings of the lower motor neuron lesions were observed high frequently in tongue muscle electromyography.
2) In 50 cases above 70 years old being apparently healthy, findings of the lower motor neuron lesions were oeserved in 46% on the tongue muscle electromyograms.
3) Hypertension was frequently seen in the patients with bulbar lesions. Different responses for blood pressure changes were seen in bulbar lesions compared with controls.
If may be concluded that electromyography of the tongue muscles is useful tool in the detection of subclinical bulbar lesions in aging, and early therapy for subclinical bulbar lesions is very important problem.