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Isolated unilateral hypoglossal nerve palsy: nine cases
O Combarros1, A Alvarez de Arcaya, J Berciano
1Service of Neurology, University Hospital Marqués de Valdecilla, Santander, Spain.
Journal of Neurology
|March 21, 1998
Summary
Isolated hypoglossal nerve palsy, often without a clear cause, typically has an excellent outcome. While metastatic disease can occur, idiopathic cases suggest a potentially benign diagnosis for this cranial nerve issue.
Area of Science:
- Neurology
- Neurosurgery
- Ophthalmology
Background:
- Isolated hypoglossal nerve palsy is a rare neurological condition.
- The etiology and prognosis of isolated hypoglossal nerve palsy are not fully understood.
- Neoplastic causes often carry an ominous prognosis, but benign causes may be underestimated.
Purpose of the Study:
- To investigate the causes and outcomes of isolated hypoglossal nerve palsy.
- To determine the frequency of idiopathic and secondary causes.
- To assess the prognostic implications of isolated hypoglossal nerve palsy.
Main Methods:
- Retrospective case series of nine patients with isolated hypoglossal nerve palsy.
- Clinical evaluation, neuroimaging, and diagnostic workup for etiological investigation.
- Follow-up to assess neurological recovery and treatment outcomes.
Main Results:
- Four patients (44%) had idiopathic isolated hypoglossal nerve palsy with excellent outcomes.
- Metastatic disease at the skull base was identified in three patients (33%).
- Chiari malformation and dural arteriovenous fistula were identified as rare causes in one patient each.
Conclusions:
- Isolated hypoglossal nerve palsy can be a benign and idiopathic condition.
- Metastatic disease is a significant cause, necessitating thorough investigation.
- The prognosis is generally favorable, especially in idiopathic cases, challenging the emphasis on neoplasia.