Isolated hypoglossal nerve palsy due to internal carotid artery dissection

A case of an isolated hypoglossal nerve palsy is reported. The differential diagnosis is discussed, in the context of the requirement for careful scrutiny of the entire course of the hypoglossal nerve on imaging, to detect underlying pathology remote from the tongue, and to avoid unnecessary invasive diagnostic procedures prompted by the appearance of a 'pseudomass' of the weak tongue both clinically and radiologically.     

Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies

Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement.     

Isolated hypoglossal nerve palsy following open surgery in the beach-chair position under general anesthesia: A case report

Hypoglossal nerve palsy frequently occurs with other cranial nerve palsies; an isolated hypoglossal nerve palsy is rare. Most hypoglossal nerve palsies are caused by tumors. However, several reports have shown an association with oropharyngeal manipulation such as intubation, laryngeal mask airway or as a complication of surgery such as carotid endarterectomy, and tooth extraction. When the nerve was injured, a deviation to the affected side, atrophy, and tongue fasciculation could be observed. We treated a patient with isolated hypoglossal nerve palsy after open repair of a fracture of the humerus in the beach-chair position.     

Unilateral spontaneous dissection of the internal carotid artery presenting as hypoglossal nerve palsy

A rare case of an isolated unilateral hypoglossal nerve palsy in a 61-year-old man is reported. Imaging showed a dissection of the extracranial internal carotid artery. The expansion of the circumference of the artery causes compression of the hypoglossal nerve resulting in a palsy. To the best of our knowledge this disorder has twice been dealt with in the otorhinolaryngological literature.     

Isolated sphenoid sinusitis presenting with unilateral VIth nerve palsy

Isolated sphenoid sinusitis is a rare disorder. There are some difficulties in its diagnosis and the first presentation of this disorder might be with complications. These complications are essentially due to the anatomical location of the sinus and its proximity to the intra-cranial and orbital contents, to which infection may easily spread. In this paper, we report a case of isolated sphenoid sinusitis in a 12-year-old girl who was presented with unilateral VIth nerve palsy. She was initially treated with parenteral antibiotherapy, the abducens nerve palsy recovered but as sphenoiditis persisted she underwent an endoscopic sphenoidotomy. We discuss the clinical features, the diagnostic tools, and the treatment options for this entity.     

Bilateral and unilateral internal carotid artery dissection causing isolated hypoglossal nerve palsy: a case report and review of the literature

Two cases of isolated hypoglossal nerve palsy due to internal carotid artery dissection are reported. In one case, a bilateral dissection was encountered. The clinical presentation and multidisciplinary management are discussed and the literature reviewed.     

Anatomy of the hypoglossal nerve and the hypoglossal ansa cervicalis

The hypoglossal nerve is the motor nerve of the tongue and the ansa cervicalis is a motor nerve for the sub-hyoid muscles. The hypoglossal nerve seems to give the innervation of the thyrohyoid although it is a sub-hyoid muscle. Most of axons in the ansa cervicalis arise from the three first cervical nerves. These nerves are in close contact because of the cervical ontogeny of the tongue and the hypoglossal nerve. Nerve impulse in the superior root of the ansa cervicalis runs caudally to rostrally. This is why neurotization techniques using the superior root of the ansa cervicalis produce poor results in the treatment of facial palsy sequelae.     

Parapharyngeal neurilemmoma of the hypoglossal nerve

Although neurilemmomas are uncommon cervical neoplasms, they account for a significant percentage of parapharyngeal space tumors. These neoplasms may originate from any nerve traversing · this space, but the vast majority arise from the vagus nerve and sympathetic chain. Satisfactory treatment of neurilemmomas consists of total excision which is best accomplished via an external approach. Immediate nerve grafting is advocated when a segment of cranial nerve must be sacrificed in order to achieve complete tumor removal. A case of a parapharyngeal neurilemmoma arising from the hypoglossal which required treatment in this manner is presented. Electromyographic studies performed 15 months postoperatively demonstrate reinervation of the lingual musculature via the nerve graft.     

Peripheral neurinoma of the hypoglossal nerve

Neurinomas of the hypoglossal nerve are rarely reported. In most cases these tumors are intracranial or sited at the skull base. Only a few solitary neurinomas of the twelfth cranial nerve have been reported. In most of these cases the tumors arose from the descending part of the nerve in the parapharyngeal space. We report the first neurinoma recorded arising from the submandibular course of the hypoglossal nerve.