Delayed hypoglossal palsy following occipital condyle fracture--case report.
Occipital condyle fractures are rare. When present, they produce lower cranial palsies and/or brainstem dysfunction. A 32 year old man sustained multiple injuries. At the time of admission the patient had no neurological deficits. Three weeks after the accident, the patient complained of slurring of speech. Clinical examination revealed an isolated hypoglossal palsy. Radiological evaluation revealed an occipital condyle fracture. The patient was treated with a rigid collar. Eighteen months after the injury, the patient noted slight improvement in his speech. However, clinical examination showed a persistent hypoglosssal palsy. Occipital condyle fractures are rare. They may be associated with lower cranial nerve palsies. As demonstrated by this case, this entity should be included in the differential diagnosis of hypoglossal palsy. Since occipital condyle fractures can exist without neurological deficits, special attention should be paid to imaging of the craniovertebral junction in patients with head injury.
Muthukumar
Natarajan
N
Department of Neurosurgery, Madurai Medical College, Madurai, 625 020, Tamil Nadu, India. natmuthu@vsnl.com
D000063:Accidents, Traffic; D000328:Adult; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D010243:Paralysis / Q000209:etiology*; D012887:Skull Fractures / Q000150:complications* / Q000000981:diagnostic imaging; D013064:Speech Disorders / Q000209:etiology; D014057:Tomography, X-Ray Computed