Isolated unilateral idiopathic transient hypoglossal nerve palsy
Abstract
A 52-year-old Caucasian man presented with sudden onset of difficulty in moving his tongue to the left with preceding left-sided headache with no neck pain. Earlier, he had self-limiting chest infection without rashes or tonsillar enlargement. His medical and surgical history was unremarkable with no recent trauma. Oral examination revealed difficulty in protruding his tongue to the left with muscle bulk loss and fasciculation on the same side, suggesting left hypoglossal nerve palsy. Examination of the rest of the cranial nerves and nervous system was normal. The patient's oropharyngeal and laryngeal examination was unremarkable with no cervical lymphadenopathy. He had normal laboratory investigations and cerebrospinal fluid examination. Extensive imaging of the head, neck and chest failed to reveal any pathology. Further review by an otorhinologist and rheumatologist ruled out any other underlying pathology. He made a good recovery without treatment. English literature search revealed very few cases of idiopathic, transient, unilateral hypoglossal nerve palsy.
Acknowledgments
The authors would like to thank Hamza Ahmed, who did the proofreading and helped with the video editing.
Footnotes
Competing interests: None.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; externally peer reviewed.
References
- 1. Lee SS, Wang SJ, Fuh JL, et al Transient unilateral hypoglossal nerve palsy: a case report. Clin Neurol Neurosurg 1994;96:148–51 [[PubMed][Google Scholar]
- 2. Parano E, Giuffrida S, Restivo D, et al Reversible palsy of the hypoglossal nerve complicating infectious mononucleosis in a young child. Neuropediatrics 1998;29:46–7 [[PubMed][Google Scholar]
- 3. Ho MW, Fardy MJ, Crean SJ. Persistent idiopathic unilateral isolated hypoglossal nerve palsy: a case report. Br Dent J 2004;196:205–7 [[PubMed]
- 4. Keane JR. Twelfth-nerve palsy. Analysis of 100 cases. Arch Neurol 1996;53:561–6 [[PubMed]
- 5. Meila D, Wetter A, Brassel F, et al Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome. J Neurol Sci 2012;323:248–9 [[PubMed][Google Scholar]
- 6. Combarros O, Alvarez de Arcaya A, Berciano J. Isolated unilateral hypoglossal nerve palsy: nine cases. J Neurol 1998;245:98–100 [[PubMed]