Tongue paralysis following head trauma

Kacker, Ashutosh; Komisar, Arnold; Kakani, Rajesh S.; Reich, E.; Rothman, Lewis M.

doi:10.1017/s0022215100131275

Cited by 22 publications

(14 citation statements)

References 4 publications

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“…Hypoglossal nerve injury should be considered in individuals with head injury who complain of dysphagia and dysarthria. 7,8 Most unilateral CN XII palsies usually resolve by 6 months 11,16 ; in this case, near-normal function of the tongue returned within 7 months. This patient serves as a reminder that CN assessments are required for even mild head injuries.…”

Section: Discussionmentioning

confidence: 79%

“…[1][2][3][4][5] Dysphagia and dysarthria are key signs for hypoglossal nerve trauma. 7,8 The hypoglossal nerve innervates the tongue and controls its functions: swallowing and speech. The nerve arises by several rootlets between the pyramids and the olives of the medulla.…”

Section: Discussionmentioning

confidence: 99%

“…4 The hypoglossal nerve can become stretched across the transverse process of C1 during hyperextension at the cranio-cervical junction. [7][8][9] Trauma to the base of the skull in the region of the occipital condyle typically occurs after significant decelerative head injuries, which are normally associated with motor vehicle crashes. 9,10 In comparison, injury during athletic participation, such as wrestling, is a relatively lowenergy mechanism.…”

Section: Discussionmentioning

confidence: 99%

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Unilateral Hypoglossal Nerve Injury in a Collegiate Wrestler: A Case Report

Loro

Owens

2009

Journal of Athletic Training

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Objective: To introduce the case of a collegiate wrestler who suffered a traumatic unilateral hypoglossal nerve injury. This case presents the opportunity to discuss the diagnosis and treatment of a 20-year-old man with an injury to his right hypoglossal nerve.Background: Injuries to the hypoglossal nerve (cranial nerve XII) are rare. Most reported cases are the result of malignancy, with traumatic causes less common. In this case, a collegiate wrestler struck his head on the wrestling mat during practice. No loss of consciousness occurred. The wrestler initially demonstrated signs and symptoms of a mild concussion, with dizziness and a headache. These concussion symptoms cleared quickly, but the athlete complained of difficulty swallowing (dysphagia) and demonstrated slurred speech (dysarthria). Also, his tongue deviated toward the right. No other neurologic deficits were observed.Differential Diagnosis: Occipital-cervical junction fracture, syringomyelia, malignancy, iatrogenic causes, cranial nerve injury.Treatment: After initial injury recognition, the athletic trainer placed the patient in a cervical collar and transported him to the emergency department. The patient received prednisone, and the emergency medicine physician ordered cervical spine plain radiographs, brain computed tomography, and brain and internal auditory canal magnetic resonance imaging. The physician consulted a neurologist, who managed the patient conservatively, with rest and no contact activity. The neurologist allowed the patient to participate in wrestling 7 months after injury.Uniqueness: To our knowledge, no other reports of unilateral hypoglossal nerve injury from relatively low-energy trauma (including athletics) exist.Conclusions: Hypoglossal nerve injury should be considered in individuals with head injury who experience dysphagia and dysarthria. Athletes with head injuries require cranial nerve assessments.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Unilateral Hypoglossal Nerve Injury in a Collegiate Wrestler: A Case Report

Loro

Owens

2009

Journal of Athletic Training

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“…[8] Post-traumatic hypoglossal nerve palsy can be due to an insult to the nerve anywhere along its anatomical pathway. A vast majority present early; the earliest to be diagnosed are bilateral palsies [5,11,12] because of the severity of the associated symptoms. [9,10] Cases of isolated hypoglossal nerve palsy can present early or late.…”

Section: Letters To Editormentioning

confidence: 99%

Unusual presentation of occipital condyle fracture

et al. 2012

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“…Cranial nerve palsies (VI, IX, X and XII) have also been reported in the past in the orthopedic but not in the anesthesia literature [2][3][4][5]. Stretch and traction forces can cause localized ischemia or changes in the position of the nerve.…”

Section: Introductionmentioning

confidence: 99%

Abducens Nerve (VI) Injury Caused by Halo-Femoral Traction: A Case Report

Abd-Elsayed

2011

J Neurol Res

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Stretch and traction on cranial nerves during surgery may cause localized ischemia or change of position of the cranial nerve leading to subsequent dysfunction. Cranial nerve palsies (VI, IX, X and XII) are the commonly affected nerves. Here we report a cranial nerve VI palsy from a halo-femoral suspension following a posterior spinal fusion. We present an 11-year-old girl with idiopathic scoliosis who was admitted for surgical correction. She had no neurological problems preoperatively. The initial video-assisted thoracoscopic anterior release and cranial bifemoral traction were uneventful. Postoperatively, ten-pound weights were added at the head and another ten were added for counter-traction. Weights were added daily in 5-pound increments. Postoperative day 2, the patient complained of "double vision" which resolved upon decreasing the traction weight only by 5 pounds. She underwent an uneventful posterior spinal fusion one week later with a total intravenous anesthesia technique; motor evoked potentials were adequate throughout the procedure. One day later, she again developed left sixth cranial nerve palsy with inability to gaze laterally. There were no other neurological defi cits, headaches or even double vision. Neurology and ophthalmology consultations excluded hypoxia/hypoperfusion as possible etiologies. The femoral pins and occipital frame were removed on day 3 in order to obtain imaging and also to remove a potential source of infection. The left lateral rectus palsy was noted to improve that same day. Radiological imaging results were ultimately normal. There is a need for frequent neurological examinations in patients in halo-tractions and prompt removal of the instrument at the fi rst sign of eye problems.

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Tongue paralysis following head trauma

Cited by 22 publications

References 4 publications

Unilateral Hypoglossal Nerve Injury in a Collegiate Wrestler: A Case Report

Unilateral Hypoglossal Nerve Injury in a Collegiate Wrestler: A Case Report

Unusual presentation of occipital condyle fracture

Abducens Nerve (VI) Injury Caused by Halo-Femoral Traction: A Case Report

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