Isolated hypoglossal nerve palsy caused by brain tumor

초록

Isolated unilateral hypoglossal nerve palsy is very uncommon with only several case reports in literature. The several diseases like head and neck trauma, neoplasia, viral infection, and tuberculosis could cause hypoglossal nerve palsy. Here we described a case of isolated HNP in a young man evoked by brain tumor. Our patient was a 34-year-old man without specific medical history like diabetes mellitus or tuberculosis. One month before admission, he suffered from vascular headache with slowly aggravation and neck pain. one week before, he developed the dysarthria. The neurologic examination showed right side deviation of the tongue. An examination including other cranial nerves and motor, sensory function revealed no abnormal findings. Brain MR scans and neck CT images indicated 1cm sized ovoid osteolytic lesion without sclerotic margin in right occiput. The initial diagnosis is primary bone tumor or metastasis and biopsy is planned. Sometimes, the patients with isolated hypoglossal nerve palsy might present only minimal dysarthria and there is high rate of underlying malignancy. The malignancy should be considered a diagnosis of exclusion in case of isolated hypoglossal nerve palsy.