Abstract
Hypoglossal nerve palsy is usually associated with glossopharyngeal nerve, vagus nerve, and accessory nerve palsy, and the occurrence of hypoglossal nerve palsy alone is rare. We report a case of a 41-year-old man with unilateral isolated hypoglossal nerve palsy. The patient was aware of a leftward deviation of the tongue along with pharyngeal pain. The pharyngeal pain was quickly relieved by antibiotic treatment, but the deviation of the tongue did not improve, and the patient was referred to our hospital. As a result of the medical examination, a single paralysis of the left hypoglossal nerve and mild swelling of the left lingual tonsil up to the left palatine tonsil were observed. Various tests were performed, but there were no significant abnormal findings other than a suggestion of mild tonsillitis. We diagnosed the patient as idiopathic or tonsillitis-induced unilateral hypoglossal nerve palsy and started medical treatment with corticosteroids and methylcobalamin. The hypoglossal nerve palsy showed a tendency to improve after one month of onset and was almost cured by two months of onset.
Highlights
The hypoglossal nerve is the 12th cranial nerve and is composed solely of motor nerves
We report a case of unilateral isolated Hypoglossal nerve palsy (HNP), which could have been secondary to tonsillitis, the cause could not be identified by various tests
There have been a few reports of HNP after bacterial tonsillitis; Kovalev and Clarenbach pointed out the possibility of the abnormal running of the hypoglossal nerve in his report [9], while Sakemi et al stated that inflammation of the periphery of the anterior wall of the hypopharynx due to lingual tonsillitis can anatomically cause inflammatory spillover to the hypoglossal nerve [10]
Summary
The hypoglossal nerve is the 12th cranial nerve and is composed solely of motor nerves. A 41-year-old man with a history of hypertension visited our hospital complaining of sore throat and left tongue deviation He was an office worker and a current smoker with 15 cigarettes a day for 20 years. He had been aware of a sore throat and a deviation of the tongue to the left side two days before he visited our department He went to see an otolaryngology practitioner, who diagnosed tonsillitis and started treatment with oral antibiotics (cefditoren-pivoxil). Only slight redness and swelling of the left palatine tonsil and lingual tonsil due to tonsillitis were observed; the symptoms of pharyngeal pain tended to improve At this point, we made a diagnosis of unilateral HNP caused by idiopathic or tonsillitis. Due to the patient’s wishes, our examinations ended at this time
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