Agrawal P, Pandey A, Sompura S, Khandelwal G, Yadav S
J Assoc Physicians India. 2014 Mar;62(3):267-8.
Bulbar Palsy is B/L impairment of function of cranial N. 9, 10, 11, 12 at lower motor neuron level either at nuclear or fascicular level in medulla or B/L lesion of lower cranial N. outside brainstem. We present case of viral hepatitis who initially presented with classical signs and symptoms of hepatitis B followed by characteristic features of bulbar palsy in form of difficulty in swallowing and slurring of speech reduced gag reflex, weak palatal movement. Other causes for bulbar palsy were excluded and indirect laryngoscopy confirmed presence of bulbar palsy. Patient had no previous neurological abnormality, there are many studies in the past for association of hepatitis B and bulbar palsy but no one confirmed about a direct association between hepatitis B and bulbar palsy. To best of knowledge this is the first case report which shows direct association between hepatitis B and bulbar palsy.
延髓麻痹是指第九、十、十一、十二对脑神经在下运动神经元水平（即在延髓的核或束状水平）双侧功能障碍，或脑干外双侧下颅神经病变。我们报告一例病毒性肝炎患者，该患者最初表现为典型的乙型肝炎体征和症状，随后出现延髓麻痹的特征性表现，如吞咽困难、言语含糊、咽反射减弱、腭运动减弱。排除了延髓麻痹的其他病因，间接喉镜检查证实存在延髓麻痹。患者既往无神经功能异常，过去有许多关于乙型肝炎与延髓麻痹相关性的研究，但均未证实乙型肝炎与延髓麻痹之间存在直接关联。据我们所知，这是第一例显示乙型肝炎与延髓麻痹之间存在直接关联的病例报告。
