1) 脑干综合征为什么总是出现交叉性瘫痪？
脑干存在受损的位置会出现一侧神经元损伤，同时对侧交叉过来的神经也会出现损伤，因而导致交叉性瘫痪。交叉性瘫痪是一侧脑干病损，由于损害已交叉的皮质脑干束纤维或颅神经与核，和未交叉的皮质脊髓束，产生交叉性瘫痪；即病灶侧的周围性脑神经麻痹和对侧肢体的中枢性偏瘫。病变同侧脑神经的周围性麻痹，对侧肢体中枢性瘫痪和偏身感觉障碍，是由于一侧运动和感觉神经核传出及传入神经纤维受到损害所致。建议及时治疗脑干梗塞，输血塞通等药物治疗

When the brain stem is damaged, one side of the neurons will be damaged, and the contralateral crossed nerves will also be damaged, resulting in cross paralysis. Chiasmatic paralysis is a unilateral brainstem lesion, which occurs due to the damage of crossed cortical brainstem bundle fibers or cranial nerve and nucleus, and uncrossed corticospinal tract; That is, peripheral cerebral palsy on the focus side and central hemiplegia of the contralateral limb. Peripheral paralysis of ipsilateral cerebral nerve, central paralysis of contralateral limb and hemisensory disturbance are caused by the damage of efferent and afferent nerve fibers of unilateral motor and sensory nerve nucleus. It is suggested to treat brainstem infarction, blood transfusion, SAITONG and other drugs in time

2) 真性球麻痹和假性球麻痹的鉴别要点是什么？

真性球麻痹是舌下神经核、运动神经元神经受损，病变位置在延髓。假性球麻痹是双侧运动神经元受损，表现为舌、软腭、咀嚼肌等病变症状，病变部位在皮质延髓束。真性球麻痹下颌反射消失，

假性者则表现为亢进；真性球麻痹咽反射消失，假性球麻痹则存在；真性球麻痹会存在强哭强笑的现象，假性球麻痹没有此表现。双侧皮质延髓束损害引起运动颅神经的上运动神经元性瘫痪
Bulbar palsy is the damage of hypoglossal nucleus and motor neurons, and the lesion is located in the medulla oblongata. Pseudobulbar palsy is the damage of bilateral motor neurons, which is manifested in the pathological symptoms of tongue, soft palate and masticatory muscle. The pathological location is in the corticomedullary tract. True bulbar paralysis, mandibular reflex disappeared,

False sex shows hyperfunction; True bulbar paralysis pharyngeal reflex disappeared, while pseudobulbar paralysis existed; There will be strong crying and laughter in true bulbar paralysis, but there is no such performance in false bulbar paralysis. Bilateral cortical medullary tract damage leads to superior motor neuron paralysis of motor cranial nerve