Hypoglossal nerve palsy secondary to cervical spine involvement in rheumatoid arthritis: Clinical and radiological features |
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| Authors: | Abdel-Rauf Zeina Alicia Nachtigal Nina Avshovich Itzhak Rosner Michael Rozenbaum |
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| Affiliation: | 1. Department of radiology, Hillel Yaffe medical center, POB 169, 38100 Hadera, Israel;2. Faculty of medicine, Technion-Israel institute of technology, Haifa, Israel;3. Department of rheumatology, Bnai Zion medical center, faculty of medicine, Technion, Haifa, Israel;1. School of Physics and Astronomy, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK;2. Institute for Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, Bournemouth, UK;3. Faculty of Science and Technology, Bournemouth University, Bournemouth, UK;1. Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China;2. Department of Orthopaedics, Central Hospital of Huangpu District, Shanghai, China;1. Department of Neurosurgery, Private Asia Hospital, Istanbul, Turkey;2. Department of Neurosurgery, I?d?r State Hospital, I?d?r, Turkey;3. Department of Neurosurgery, Liv Hospital, Istanbul, Turkey;4. Department of Neurosurgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey |
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| Abstract: | Isolated hypoglossal nerve (HN) palsy has been reported in a variety of disorders involving the cervical spine and/or skull base, however, unilateral HN palsy caused by rheumatoid arthritis (RA) has rarely been reported. We report herein an uncommon case of isolated HN palsy secondary to RA cervical spine involvement: pannus formation at the C1–C2 articulation, atlanto-axial subluxation, as well as, erosion of the right occipital condyle, lateral mass and anterior arch of C1. Pulse therapy with methylprednisolone followed by maintenance therapy with prednisone resulted in dramatic improvement. We also present the variety of diagnostic modalities helpful for the diagnosis and follow-up. |
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