So ciliary pain is referred to areas associated with cervical segments which connect with the superior cervical ganglion and the somatic outflow from which is represented by bulbospinal
root of trigeminal and upper cervical nerves.
These include bilateral Bell's palsy, diabetes, Guillain-Barre syndrome, viral infections, syphilis, basal skull fractures, pregnancy, brainstem encephalitis, cryptococcal meningitis, systemic lupus erythematosus, bulbospinal
muscular atrophy and borreliosis.
4,5) Specific genetic tests are available for X-linked bulbospinal
neuronopathy (Kennedy's disease), which causes a slowly progressive lower motor neurone syndrome, sensory neuropathy, and partial androgen insensitivity leading to gynaecomastia and the recessive form of proximal spinal muscular atrophy which can occasionally come on in adult life.
The author was initially given two synonyms for SBMA by a physician: Kennedy disease and X-linked bulbospinal neuronopathy.
Expression of X-linked bulbospinal muscular atrophy [Kennedy disease] in two homozygous women.
Alexanders (type 2), which primarily has an adult onset with the presence of muscle weakness, hyperreflexia, bulbar or pseudobulbar symptoms, signal abnormalities and atrophy observed in an MRI of the medulla oblongata and upper cervical spinal cord
The fatal sequelae of this type of bite are bulbospinal
paralysis, including respiratory paralysis.
Another potential contribution to the pain-generating mechanism is the role of descending bulbospinal
The symptoms of detrusor hyperreflexia, such as frequency, urge incontinence, and incomplete emptying, are caused by spinal cord plaques disrupting the bulbospinal
pathways from the pontine micturition center (Dierich, 2000; Goodwin & Fowler, 1997; MSCCPG, 1999; Schapiro, 1998).
Giordano's recent review of pain modulatory mechanisms described the involvement of several systems, including, but not limited to, intraspinal-segmental pain modulation, bulbospinal
pain modulation, centrifugal pain modulation involving midbrain and descending inhibitory controls, opioid and nonopioid hypothalamicpituitary analgesia, and corticolimbic inhibitory processing .