An Unusual Case of Isolated Hypoglossal Nerve Palsy Secondary to Osteophytic Projection from the Atlanto-Occipital Joint

Patro, Satya; Torres, Carlos; Riascos, Roy

doi:10.15274/nrj-2014-10039

Cited by 12 publications

(12 citation statements)

References 10 publications

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“…Hypoglossal palsy secondary to atlanto-occipital osteophytes has been previously described in single-case reports. 9,10 In our 2 patients with hypoglossal palsy secondary to C1-occipital osteophytes, osteophyte encroachment and secondary hypoglossal canal wall erosions were observed at the external ostium. This external canal encroachment is in contrast to ROFPs and CCJ JACs, which encroach on the internal ostium, and commonly extended within and/or through the hypoglossal canal.…”

Section: Atlanto-occipital Osteophytesmentioning

confidence: 73%

“…Skull base invasion of nasopharyngeal carcinoma, radiation-induced neuropathy, hypoglossal neuritis, and schwannomas or secondary nerve compression by meningioma, aneurysm, arachnoid cyst, and occipital condyle fracture are also commonly included in the differential diagnosis. 1,2,4,5,[8][9][10] Our series of 18 patients with hypoglossal palsy secondary to JACs, ROFPs, and osteophytes is, to our knowledge, the largest series with underlying CCJDD pathologic causes. In this retrospective series, perceptual and interpretive errors in diagnosis led to an underreporting of these lesions as the cause for hypoglossal palsy.…”

Section: Discussionmentioning

confidence: 88%

“…By using a segmental approach, 1 the underlying etiologic factors can be subdivided by location as involving the brain stem, premedullary cistern, skull base, nasopharynx or oropharynx, or sublingual regions. Hypoglossal nerve palsy secondary to craniocervical junction (CCJ) juxta-articular (synovial and ganglion) cysts [2][3][4][5][6][7][8] and osteophytes 9,10 has been described in isolated case reports; yet, these pathologies are not classically included in the differential diagnosis for hypoglossal palsy. Distinguishing CCJ degenerative lesions from other hypoglossal nerve pathologies might have important diagnostic and treatment implications.…”

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confidence: 99%

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Is Hypoglossal Nerve Palsy Caused by Craniocervical Junction Degenerative Disease an Underrecognized Entity?

Weindling

Goff

Wood

et al. 2016

AJNR Am J Neuroradiol

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Isolated hypoglossal nerve palsy is uncommon, and underlying craniocervical junction degenerative disease has rarely been reported as an underlying cause. To improve understanding of this entity, we present a retrospective series of 18 patients with hypoglossal palsy in whom twelfth cranial nerve compression within the premedullary cistern or hypoglossal canal, or both, was found secondary to craniocervical junction juxta-articular cysts, retro-odontoid fibrous pseudotumors, and osteophytes. The imaging techniques and characteristic craniocervical junction degenerative disease lesion imaging findings presented here might help clinicians interpreting hypoglossal palsy imaging studies avoid perceptual and interpretive errors commonly found in the present series.

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Section: Atlanto-occipital Osteophytesmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

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Is Hypoglossal Nerve Palsy Caused by Craniocervical Junction Degenerative Disease an Underrecognized Entity?

Weindling

Goff

Wood

et al. 2016

AJNR Am J Neuroradiol

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“…Other causes of isolated cranial nerve XII palsy include infectious sequelae from dengue fever, mononucleosis, and tuberculosis [ 41–43 ]. Autoimmune, vascular conditions, and mechanical compression secondary to osteophyte projection of the atlanto-occipital joint have also resulted in cranial nerve XII palsy [ 44 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Isolated Hypoglossal Nerve Palsy as a Presenting Symptom of Metastatic Peripheral T-Cell Lymphoma – not Otherwise Specified (PTCL–NOS): A Unique Case & a Review of the Literature

Bryer

Henry

2018

Int. J. Hematol. Oncol.

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Extensive and significant technological advancements have enhanced the sensitivity and accuracy of the pathologic classification, diagnosis, and therapeutics of lymphoma. These advances have prompted a more comprehensive understanding of neoplastic behavior and have led to improvements in both treatment and prognosis. This paper presents a comprehensive review of lymphoma and features a case report of a unique presentation of peripheral T-cell lymphoma – not otherwise specified that presented with isolated hypoglossal nerve dysfunction.

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“…[6] Even though cervical myeloradiculopathy due to Degenerative disc disease is not an uncommon encounter in a neurology clinic, isolated hypoglossal nerve palsy is rare. [7] We report a case of a rare isolated hypoglossal nerve palsy due to a hypoglossal schwannoma coexisting with cervical myeloradiculopathy due to occupation related degenerative disc disease, clinically mimicking ALS. She is a tea plucker who carries tea leaves on her shoulders and works long shifts.…”

Section: Introductionmentioning

confidence: 98%

Cervical myeloradiculopathy with Hypoglossal Schwannoma mimicking Amyotrophic lateral sclerosis: a Case report

Ambawatte

Weerathunga

Dissanayake

et al. 2019

Preprint

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Background: A presentation of upper motor and lower motor clinical signs without sensory impairment may suggest Amyotrophic lateral sclerosis, especially when it involves limbs and bulbar regions. However, co-existence of two or more unrelated pathologies can give rise to a clinical picture similar to Amyotrophic lateral sclerosis. Case presentation: A 45 year old lady presented with slowly progressive right upper limb weakness for 6 months and mild left upper limb weakness for 2 months associated with muscle twitching. Her family members have noticed a change in character of her speech for few weeks. She couldn’t recall a radicular pain at any given time. On examination, her right deltoid was wasted with numerous fasciculations over right proximal muscles. Right shoulder movements were weak. Her left deltoid was slightly wasted and fasciculations were appreciated. Her both biceps and supinator jerks were normal with exaggerated triceps jerks and positive Hoffman sign. Sensory and proprioception examinations were unremarkable. Both lower limbs were hypertonic with exaggerated knee and ankle jerks. Ankle clonus was absent and plantar responses were equivocal. Her tongue was deviated to right side with fascicuations and wasting of right side. Palatal movements and Jaw jerk were normal. She was clinically diagnosed as possible amyotrophic lateral sclerosis. Electromyography showed denervation changes in deltoids and biceps with right predominance and right genioglossus muscle too showed denervation changes. Magnetic resonant imaging of brain stem was undertaken especially because her tongue wasting and fasciculations were unilateral and it showed a right sided hypoglossal schwannoma. Magnetic resonant imaging of cervical spine revealed degenerative disk disease with mild cord compression and exit foramina narrowing at multiple levels. Conclusions: Pure motor symptoms with a mixture of upper motor and lower motor signs may suggest a clinical diagnosis of Amyotrophic lateral sclerosis. However, when there are rare manifestations of a relatively common disease, such as unilateral tongue involvement as in the above scenario, a higher degree of clinical suspicion is needed to think of a dual pathology. Keywords: Hypoglossal schwannoma, cervical myeloradiculopathy, Amyotrophic lateral sclerosis, dual pathology.

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An Unusual Case of Isolated Hypoglossal Nerve Palsy Secondary to Osteophytic Projection from the Atlanto-Occipital Joint

Abstract: SUMMARY -

Cited by 12 publications

References 10 publications

Is Hypoglossal Nerve Palsy Caused by Craniocervical Junction Degenerative Disease an Underrecognized Entity?

Is Hypoglossal Nerve Palsy Caused by Craniocervical Junction Degenerative Disease an Underrecognized Entity?

Isolated Hypoglossal Nerve Palsy as a Presenting Symptom of Metastatic Peripheral T-Cell Lymphoma – not Otherwise Specified (PTCL–NOS): A Unique Case & a Review of the Literature

Cervical myeloradiculopathy with Hypoglossal Schwannoma mimicking Amyotrophic lateral sclerosis: a Case report

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