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Updated: May 20, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Metastatic disease causing unilateral isolated hypoglossal nerve palsy
1Department of Neurology, Kingston Hospital, Surrey, UK. rfernandes@doctors.org.uk
Abstract:
The authors present the case of a middle-aged woman diagnosed with lobar carcinoma in situ in her right breast. She eventually underwent a mastectomy and reconstruction. Histology revealed grade II invasive ductal carcinoma and she was commenced on adjuvant letrozole. The following year a MRI scan revealed she had developed spinal metastases and CT confirmed the presence of liver and lung metastases. She presented with a 5-month history of tongue weakness and difficulty manipulating food to the back of her mouth. On examination, there was marked right-sided hemiatrophy of the tongue with deviation of the tongue to the right side upon protrusion. MRI demonstrated ill-defined enhancing material close to the intracranial opening of the right hypoglossal canal. The patient was referred for consideration of radiotherapy. Due to the comorbidities of the patient, she was not a candidate for neurosurgical intervention.
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