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[Isolated hypoglossal nerve paralysis: a case report].

Güçlü Kaan Beriat¹, Hande Ezerarslan, Sinan Kocatürk

¹Ufuk Üniversitesi Tip Fakültesi Kulak Burun Boğaz Hastaliklari Anabilim Dali, Ankara, Turkey.

Kulak Burun Bogaz Ihtisas Dergisi : KBB = Journal of Ear, Nose, and Throat

|July 15, 2010

Summary

Isolated hypoglossal nerve paralysis after radiotherapy for nasopharyngeal carcinoma can indicate recurrence. However, this case highlights that it may also be a late side effect of radiation treatment.

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Area of Science:

Neurology
Oncology
Radiotherapy

Background:

Cranial nerve paralysis is a rare complication following radiotherapy for head and neck cancers, with an incidence of 1-5%.
The hypoglossal nerve (CN XI) is particularly sensitive, and isolated paralysis is often a concerning indicator of nasopharyngeal carcinoma recurrence.

Observation:

A 45-year-old male presented with tongue movement difficulty and dysphagia 5 years post-radiotherapy and chemotherapy for nasopharyngeal carcinoma.
Initial suspicion for isolated hypoglossal nerve paralysis was tumor recurrence.

Findings:

Detailed examinations revealed that the paralysis was not due to tumor recurrence.
The etiology was identified as late radiation toxicity, a known but uncommon complication.

Implications:

This case underscores the importance of considering late radiation toxicity in the differential diagnosis of cranial nerve palsies post-treatment.
Distinguishing between recurrence and treatment side effects is crucial for appropriate patient management and prognosis in nasopharyngeal carcinoma survivors.