Swallowing and choking is usually due to the occurrence of bulbar palsy, which is a relatively common clinical syndrome and is divided into true bulbar palsy and pseudobulbar palsy. Most of them have brainstem lesions, or nerve nucleus damage, or local muscle damage. Examples of brainstem lesions include brainstem tumors, brainstem hemorrhage, brainstem infarction, brainstem cavernous hemangioma, or brainstem encephalitis. Cranial nerve lesions, on the other hand, are most likely to present with symptoms of bulbar palsy when multiple groups of cranial neuritis involve the posterior group of cranial nerves. In addition, myasthenia gravis and Guillain-Barre syndrome can also lead to dysfunction of the muscles of the pharynx and, more rarely, amyotrophic lateral sclerosis. Pseudobulbar palsy is relatively rare and is caused by simultaneous damage to both cerebral hemispheres. Patients most commonly suffer from multiple cerebral infarcts or tumorigenic disease involving both hemispheres.