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The term "bulbar" refers to the medulla oblongata, a bulb-like swelling at the top of the spinal cord. The bulbar nerves are cranial nerves 9 through 12. Damage to these nerves can impair swallowing and speech, and weaken neck muscles. This can lead to choking and breathing difficulties due to the inability to swallow or clear secretions, and aspiration of food or saliva into the lungs. Early signs include a nasal voice and weak cough. Causes of bulbar palsy include motor neuropathies like diphtheria, polio, and botulism, as well as motor neuron diseases, myasthenia gravis, certain muscle diseases, and nerve compression from tumors. Cranial nerves connect the head and upper torso's muscles and sense organs directly to the brain.12

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