Hostname: page-component-76d6cb85b7-f97m6 Total loading time: 0 Render date: 2026-07-26T11:10:40.451Z Has data issue: false hasContentIssue false
  • English
  • Français

Isolated hypoglossal nerve palsy: a harbinger of malignancy

Published online by Cambridge University Press:  13 February 2007

S G Khoo ,
I Ullah ,
F Wallis  and
J E Fenton
S G Khoo*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
I Ullah
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
F Wallis
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
J E Fenton
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
*
Address for correspondence: Mr S G Khoo, 62 Hybreasal House, Kilmainham, Dublin 8, Ireland. E-mail: sgkhoo@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

The hypoglossal nerve is an underrated nerve usually consigned to a few words in anatomical text books, under the last four cranial nerves. However, paralysis of this nerve may be the first indication of a serious underlying disorder. Excluding previous surgery, radiotherapy and trauma, 50 per cent of cases of isolated hypoglossal nerve palsy are idiopathic. A further 20 per cent are malignant, 20 per cent are vascular and 10 per cent are due to miscellaneous causes. Presentation of an isolated hypoglossal nerve palsy is therefore an ominous sign. There is confusion over both cause and investigation, and management protocols for isolated hypoglossal nerve palsy are ill-defined. We present a case of isolated hypoglossal palsy which was due to a metastatic skull base deposit. This case illustrates the fact that magnetic resonance imaging is the investigation of choice in assessing the entire course of the hypoglossal nerve.

Keywords

Hypoglossal NerveHead and Neck NeoplasmsDiagnostic ImagingNeoplasm Metastasis

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 8 , August 2007 , pp. 803 - 805
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Combarros, O, Alvarez de Arcaya, A, Berciano, J. Isolated unilateral hypoglossal nerve palsy: nine cases. J Neurol 1998;245:98–100Google Scholar
2Shahab, R, Savy, LE, Croft, CB, Hung, T. Isolated hypoglossal nerve palsy due to internal carotid artery dissection. J Laryngol Otol 2001;115:587–9CrossRefGoogle ScholarPubMed
3Blomquist, MH, Barr, JD, Hurst, RW. Isolated unilateral hypoglossal neuropathy caused by dural arteriovenous fistula. Am J Neuroradiol 1998;19:951–3Google ScholarPubMed
4Omura, S, Nakajima, Y, Kobayashi, S, Ono, S, Fujita, K. Oral manifestations and differential diagnosis of isolated hypoglossal nerve palsy: report of two cases. Oral Surg Oral Med Oral Pathol 1997;84:635–40CrossRefGoogle ScholarPubMed
5Hoare, TJ, Manjalay, G, Proops, DW. Isolated hypoglossal nerve palsy caused by carotid artery aneurysm. J Roy Soc Med 1993;86:548–9Google ScholarPubMed
6Giuffrida, S, Lo Bartolo, ML, Nicoletti, A, Reggio, E, Lo Fermo, S, Restivo, DA et al. Isolated unilateral reversible palsy of the hypoglossal nerve. Eur J Neurol 2000;7:347–9CrossRefGoogle ScholarPubMed
7Thompson, EO, Smoker, WRK. Hypoglossal nerve palsy: a segmental approach. Radiographics 1994;4:939–58CrossRefGoogle Scholar
8Tommasi-Davenas, C, Vighetto, A, Confavreux, C, Aimard, G. Causes of paralysis of the hypoglossal nerve. Apropos of 32 cases [in French]. Presse Med 1990;18:864–8Google Scholar
9Syms, MJ, Tanaka Singson, M, Burgess, LPA. Evaluation of lower cranial nerve deficits. Otolaryngol Clin North Am 1997;30:849–63CrossRefGoogle ScholarPubMed
10Lindsay, FW, Mullin, D, Keefe, MA. Subacute hypoglossal nerve paresis with internal carotid artery dissection. Laryngoscope 2003;113:1530–3CrossRefGoogle ScholarPubMed
11Keane, JR. Twelfth-nerve palsy; analysis of 100 cases. Arch Neurol 1996;53:561–6CrossRefGoogle ScholarPubMed
12Castling, B, Hicks, K. Traumatic isolated unilateral hypoglossal nerve palsy – case report and review of the literature. Brit J Oral Maxillofac Surg 1995;33;171–3Google Scholar
13Bagan-Senastian, JV, Milian-Masanet, MA, Penarrocha-Diago, M, Lloria de Miguel, E. Persistent idiopathic unilateral hypoglossal nerve palsy. J Oral Maxillofac Surg 1998;56;507–10Google Scholar
14Ho, MWS, Fardy, MJ, Crean, SJV. Persistent idiopathic unilateral isolated hypoglossal nerve palsy; a case report. Brit Dent J 2004;196:205–7Google Scholar
15Wilding, LJ, Howlett, DC, Anderson, HJ, Sangle, PD, Violaris, N, Evans, GH. Extracranial internal carotid artery aneurysm presenting as symptomatic hypoglossal and glossopharyngeal nerve paralysis. J Laryngol Otol 2004;118:150–2CrossRefGoogle ScholarPubMed
16Kaushik, V, Kelly, G, Richards, SD, Saeed, S. Isolated unilateral hypoglossal nerve palsy after minor head trauma. Clin Neurol Neurosurg 2002;105:42–7Google Scholar
17Spitzer, C, Mull, M, Topper, R. Isolated hypoglossal nerve palsy caused by carotid artery dissection – the necessity of MRI for diagnosis. J Neurol 2001;248:909–10Google Scholar