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Neuroimaging abnormalities with hypoglossal nerve palsies
T T Batchelor1, G S Krol, L M DeAngelis
1Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Summary
Hypoglossal nerve lesions can cause tongue paralysis, leading to an expanded tongue base visible on MRI. These imaging findings reflect nerve injury and muscle denervation processes.
Area of Science:
- Neurology
- Radiology
- Pathophysiology
Background:
- Unilateral hypoglossal nerve lesions can result in tongue paralysis.
- Accurate diagnosis of nerve lesions is crucial for patient management.
Observation:
- Seven patients with acute or chronic unilateral hypoglossal nerve lesions were evaluated.
- Imaging studies included magnetic resonance imaging (MRI) and computed tomography (CT).
Findings:
- Acute to subacute tongue paralysis showed an expanded ipsilateral tongue base.
- Increased signal intensity on T2-weighted MRI images was observed.
- Radiographic findings mimicked an infiltrative mass lesion within the tongue.
Implications:
- These imaging characteristics are indicative of nerve injury and subsequent muscle denervation.
- Understanding these specific radiographic signs aids in diagnosing hypoglossal nerve dysfunction.
- Distinguishing nerve injury from a true mass lesion is critical for appropriate treatment planning.