Isolated Hypoglossal Nerve Palsy Due to an Osteophyte with Atlantoaxial Dislocation

Ozaki, Ko; Yamakami, Iwao; Higuchi, Yoshinori; Fukutake, Toshio

doi:10.2176/nmccrj.cr.2019-0306

Cited by 2 publications

(2 citation statements)

References 8 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This rotation narrows the space available between C1 and C2 ( 16 ). There are not many cases of isolated hypoglossal nerve palsy after injury; one case reported unilateral hypoglossal nerve palsy following a vertical atlantoaxial dislocation ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Isolated bilateral hypoglossal nerve paralysis following an atlanto-occipital dislocation: A case report

et al. 2022

View full text Add to dashboard Cite

The present report highlights a case of successful treatment of an 11-year-old male patient who presented with an atlanto-occipital dislocation and multiple fractures of the forearm, pelvis, and lower leg because of a fall. The patient experienced dysarthria and paralysis of the tongue, which became completely immobile and could not be moved from side to side, impeding speech. The patient also experienced dysphagia due to the inability to propel food toward the pharynx and chewing attempts resulted in scattering of food residue throughout the oral cavity. The lack of tongue mobility led to saliva accumulation, forcing the patient to swallow frequently, which was possible as larynx movement was unaffected. The other cranial and motor sensory nerves appeared normal. Our diagnostic examinations confirmed the presence of isolated bilateral paralysis of the hypoglossal nerve secondary to traction at the base of the skull. The patient was still unable to protrude his tongue and tongue gradually atrophied two weeks after admission. Electromyography revealed denervation of the tongue and minimal active contraction of the single motor units. Immobilization therapy and rehabilitation therapy were initiated to improve tongue movement, but this was unsuccessful and one month after the accident, the patient's tongue was still atrophied. The patient was placed on a soft food diet and experienced no difficulty in swallowing either saliva or food three months after admission. Tongue mobility was deemed normal. Electromyography six months after the initial episode revealed normal motor unit potentials during contractions. We postulate that compression and stretching of the bilateral hypoglossal nerves against the greater horn of the hyoid bone was a probable cause of the hypoglossal palsy. The use of immobilization and rehabilitation therapy likely supported the recovery of functionality and resulted in a good prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Isolated bilateral hypoglossal nerve paralysis following an atlanto-occipital dislocation: A case report

et al. 2022

View full text Add to dashboard Cite

show abstract

“…One of the most unusual causes of HN neuropathy is compression induced by osteophytes at the exit from the hypoglossal canal. Ozaki et al [128] describe the case of a patient who suffered from atlantoaxial dislocation with osteophyte involvement with concomitant rheumatoid arthritis. In a similar case, an osteophyte was found to arise from the atlantoaxial joint and induce neurological symptoms related to the HN (Figure 5) [129,130].…”

Section: Osteophytesmentioning

confidence: 99%

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Węgiel,

Zielinska,

Głowacka

et al. 2024

Biomedicines

View full text Add to dashboard Cite

The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

show abstract

Isolated Hypoglossal Nerve Palsy Due to an Osteophyte with Atlantoaxial Dislocation

Cited by 2 publications

References 8 publications

Isolated bilateral hypoglossal nerve paralysis following an atlanto-occipital dislocation: A case report

Isolated bilateral hypoglossal nerve paralysis following an atlanto-occipital dislocation: A case report

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Contact Info

Product

Resources

About