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Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy
INTRODUCTION: The authors report a rare cause of isolated hypoglossal nerve palsy caused by a high cervical osteophyte. This case increases clinical knowledge of an underreported condition and teaches the clinician radiologic pearls in making the diagnosis. To their knowledge, this is the first case...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Hindawi
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708331/ https://www.ncbi.nlm.nih.gov/pubmed/36458134 http://dx.doi.org/10.1155/2022/2884145 |
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author | Tesson, Alan Kranz, Peter Zomorodi, Ali Morgenlander, Joel |
author_facet | Tesson, Alan Kranz, Peter Zomorodi, Ali Morgenlander, Joel |
author_sort | Tesson, Alan |
collection | PubMed |
description | INTRODUCTION: The authors report a rare cause of isolated hypoglossal nerve palsy caused by a high cervical osteophyte. This case increases clinical knowledge of an underreported condition and teaches the clinician radiologic pearls in making the diagnosis. To their knowledge, this is the first case report showing surgical remediation of this condition. Symptoms and Clinical Findings. A 73-year-old female presented with several months of occipital headache, progressive dysarthria, dysphagia, and tongue deviation to the right. Her neurologic exam was significant for atrophy of the right hemitongue with tongue fasciculations. On protrusion, her tongue deviated rightward. Diagnosis and Therapeutic Intervention. Careful review of her initial head computed tomography (CT) imaging revealed that a high cervical osteophyte caused unilateral, isolated hypoglossal nerve palsy. Neurosurgery performed a right, far lateral approach for decompression of this osteophyte and over the ensuing months her symptoms improved. CONCLUSION: High cervical osteophyte is an underrecognized cause of isolated hypoglossal nerve palsy. The imaging investigation should be systematic and focus on the skull base with magnetic resonance imaging (MRI) or CT. This is a rare occasion when high resolution CT of the skull base can actually be the more helpful imaging modality. As shown in this case, an osteoarthritic cause can be surgically ameliorated. |
format | Online Article Text |
id | pubmed-9708331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-97083312022-11-30 Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy Tesson, Alan Kranz, Peter Zomorodi, Ali Morgenlander, Joel Case Rep Neurol Med Case Report INTRODUCTION: The authors report a rare cause of isolated hypoglossal nerve palsy caused by a high cervical osteophyte. This case increases clinical knowledge of an underreported condition and teaches the clinician radiologic pearls in making the diagnosis. To their knowledge, this is the first case report showing surgical remediation of this condition. Symptoms and Clinical Findings. A 73-year-old female presented with several months of occipital headache, progressive dysarthria, dysphagia, and tongue deviation to the right. Her neurologic exam was significant for atrophy of the right hemitongue with tongue fasciculations. On protrusion, her tongue deviated rightward. Diagnosis and Therapeutic Intervention. Careful review of her initial head computed tomography (CT) imaging revealed that a high cervical osteophyte caused unilateral, isolated hypoglossal nerve palsy. Neurosurgery performed a right, far lateral approach for decompression of this osteophyte and over the ensuing months her symptoms improved. CONCLUSION: High cervical osteophyte is an underrecognized cause of isolated hypoglossal nerve palsy. The imaging investigation should be systematic and focus on the skull base with magnetic resonance imaging (MRI) or CT. This is a rare occasion when high resolution CT of the skull base can actually be the more helpful imaging modality. As shown in this case, an osteoarthritic cause can be surgically ameliorated. Hindawi 2022-11-22 /pmc/articles/PMC9708331/ /pubmed/36458134 http://dx.doi.org/10.1155/2022/2884145 Text en Copyright © 2022 Alan Tesson et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Tesson, Alan Kranz, Peter Zomorodi, Ali Morgenlander, Joel Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title | Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title_full | Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title_fullStr | Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title_full_unstemmed | Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title_short | Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy |
title_sort | something got your tongue? a unique cause of hypoglossal nerve palsy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708331/ https://www.ncbi.nlm.nih.gov/pubmed/36458134 http://dx.doi.org/10.1155/2022/2884145 |
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