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...

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Main Authors: Alan Tesson, Peter Kranz, Ali Zomorodi, Joel Morgenlander
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2022/2884145
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author Alan Tesson
Peter Kranz
Ali Zomorodi
Joel Morgenlander
author_facet Alan Tesson
Peter Kranz
Ali Zomorodi
Joel Morgenlander
author_sort Alan Tesson
collection DOAJ
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.
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spelling doaj-art-6f0ae8e6bdea45d3b6b99619f4ffa7052025-08-20T02:06:20ZengWileyCase Reports in Neurological Medicine2090-66762022-01-01202210.1155/2022/2884145Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve PalsyAlan Tesson0Peter Kranz1Ali Zomorodi2Joel Morgenlander3Inova Neuroscience Service LineDepartment of RadiologyDepartment of NeurosurgeryDepartment of NeurologyIntroduction. 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.http://dx.doi.org/10.1155/2022/2884145
spellingShingle Alan Tesson
Peter Kranz
Ali Zomorodi
Joel Morgenlander
Something Got Your Tongue? A Unique Cause of Hypoglossal Nerve Palsy
Case Reports in Neurological Medicine
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
url http://dx.doi.org/10.1155/2022/2884145
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AT alizomorodi somethinggotyourtongueauniquecauseofhypoglossalnervepalsy
AT joelmorgenlander somethinggotyourtongueauniquecauseofhypoglossalnervepalsy