Conhecendo a síndrome pseudobulbar: considerações anatomofisiológicas, fonoaudiológicas e clínicas

Abstract

The pseudobulbar syndrome is characterized by dysarthria, dysphagia and disphonia, deficiency of the voluntary movements of the tongue and facial muscles and emotional lability. It is caused by bilateral injury of the supranuclear bulbar afferences determined by different etiological factors like cerebrovascular disorders, traumatic brain injury, diseases of the upper motor neuron and multiple sclerosis. The difficulties found by the speech-language pathologists in understanding the mechanisms of the neural control of deglutition and speech, which are essential for the diagnosis and therapy of these systems disturbances, is the reason of this research. These study were made in order to review the specialized literature about the pseudobulbar syndrome, focusing its anatomophysiological, physiopathological, clinical and speech-language pathological features. An ample and non-systematic literature review was made in different databases and other sources, such as textbooks and journal articles and texts from specialized pages available on the Internet. From the knowledge obtained on the literature review, the following conclusions, among others, can be taken: a) the pseudobulbar syndrome has multiform etiology but the determinant injuries should affect bilaterally the corticopontines and corticobulbar supranuclear motor paths; b) there are functional disorders in the organs related to articulation, phonation, mastication and swallowing; c) its speech-language and swallowing manifestations demand treatment with specific objective in promoting better communication skills as well as feeding improvements thus giving the patient a better quality of life; d) the full knowledge of the anatomophysiology of the structures and the physiopathology of the mechanisms involved in speech and swallowing is essential to those who work with diagnosis and therapy of patients with these kind of damage.