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Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report

INTRODUCTION AND IMPORTANCE: Hypoglossal nerve palsy is a rare condition usually associated with tumors, trauma, stroke or multiple sclerosis. It can be associated with other cranial nerve palsies while injury to this nerve typically affects a patient's articulation by causing lingual motility...

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Autores principales: Brattou, Panagiota, Iliakopoulos, Konstantinos, Anagnostou, Evangelos, Zambelis, Thomas, Polydorou, Andreas, Theodoraki, Kassiani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284038/
https://www.ncbi.nlm.nih.gov/pubmed/35803095
http://dx.doi.org/10.1016/j.ijscr.2022.107387
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author Brattou, Panagiota
Iliakopoulos, Konstantinos
Anagnostou, Evangelos
Zambelis, Thomas
Polydorou, Andreas
Theodoraki, Kassiani
author_facet Brattou, Panagiota
Iliakopoulos, Konstantinos
Anagnostou, Evangelos
Zambelis, Thomas
Polydorou, Andreas
Theodoraki, Kassiani
author_sort Brattou, Panagiota
collection PubMed
description INTRODUCTION AND IMPORTANCE: Hypoglossal nerve palsy is a rare condition usually associated with tumors, trauma, stroke or multiple sclerosis. It can be associated with other cranial nerve palsies while injury to this nerve typically affects a patient's articulation by causing lingual motility disturbance and swallowing difficulty. Bilateral isolated hypoglossal nerve palsy is an even more infrequent condition, which can occasionally be due to airway manipulation. CASE PRESENTATION: We describe a case of bilateral hypoglossal nerve damage following general anesthesia for emergency surgery, presenting with dysarthria, immobility of the tongue and dysphagia after extubation. The patient had a gradual recovery of all lost functions during the next four months. CLINICAL DISCUSSION: Bilateral hypoglossal nerve palsy is a very rare entity and tracheal tube malposition or prolonged but unnoticed tracheal cuff pressure especially in the face of low blood pressure, should be considered as possible causative mechanisms for this condition. This underlines the importance of careful positioning of the patient's head and neck during surgery as well as the meticulous and correct performance of routine maneuvers of airway management. CONCLUSION: Bilateral hypoglossal nerve palsy is a very rare entity. Diagnosis and management of twelfth nerve palsy require a multidisciplinary approach to achieve the best patient outcome.
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spelling pubmed-92840382022-07-16 Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report Brattou, Panagiota Iliakopoulos, Konstantinos Anagnostou, Evangelos Zambelis, Thomas Polydorou, Andreas Theodoraki, Kassiani Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Hypoglossal nerve palsy is a rare condition usually associated with tumors, trauma, stroke or multiple sclerosis. It can be associated with other cranial nerve palsies while injury to this nerve typically affects a patient's articulation by causing lingual motility disturbance and swallowing difficulty. Bilateral isolated hypoglossal nerve palsy is an even more infrequent condition, which can occasionally be due to airway manipulation. CASE PRESENTATION: We describe a case of bilateral hypoglossal nerve damage following general anesthesia for emergency surgery, presenting with dysarthria, immobility of the tongue and dysphagia after extubation. The patient had a gradual recovery of all lost functions during the next four months. CLINICAL DISCUSSION: Bilateral hypoglossal nerve palsy is a very rare entity and tracheal tube malposition or prolonged but unnoticed tracheal cuff pressure especially in the face of low blood pressure, should be considered as possible causative mechanisms for this condition. This underlines the importance of careful positioning of the patient's head and neck during surgery as well as the meticulous and correct performance of routine maneuvers of airway management. CONCLUSION: Bilateral hypoglossal nerve palsy is a very rare entity. Diagnosis and management of twelfth nerve palsy require a multidisciplinary approach to achieve the best patient outcome. Elsevier 2022-07-05 /pmc/articles/PMC9284038/ /pubmed/35803095 http://dx.doi.org/10.1016/j.ijscr.2022.107387 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Brattou, Panagiota
Iliakopoulos, Konstantinos
Anagnostou, Evangelos
Zambelis, Thomas
Polydorou, Andreas
Theodoraki, Kassiani
Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title_full Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title_fullStr Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title_full_unstemmed Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title_short Bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. A case report
title_sort bilateral palsy of the hypoglossal nerve following general anesthesia for emergency surgery. a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284038/
https://www.ncbi.nlm.nih.gov/pubmed/35803095
http://dx.doi.org/10.1016/j.ijscr.2022.107387
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