1. Progressive bulbar paralysis is a subtype of amyotrophic lateral sclerosis characterized by atrophy of motor cranial nerve nuclei in the brainstem. 2. It causes weakness of the muscles involved in swallowing and speech leading to drooling, difficulty chewing and talking, and risk of aspiration pneumonia. 3. Symptoms start around age 50-70 and progressively worsen over 1 to 3 years ultimately resulting in respiratory failure and death.