Isolated unilateral hypoglossal nerve palsy due to vertebral artery dissection.
We report the case of a patient with unilateral tongue weakness secondary to an isolated lower motor neuron hypoglossal nerve palsy that was caused by a right vertebral artery dissection in the lower neck. The patient had a boggy tongue with a deviation to the right side but an otherwise normal neurological examination. Magnetic resonance angiography showed a narrow lumen of the right vertebral artery in the neck. After initially treating the patient with aspirin in the emergency room and later with warfarin for three months, there was complete recanalization of the right vertebral artery. Only one other case of vertebral artery dissection and twelfth nerve palsy has been reported before.
Department of Neurology, Quincy Medical Center/Alzheimer’s Disease Center, Quincy, Massachusetts 02169, USA.
Karthik
K
Mahadevappa
Thomas
T
Chacko
Anil K
AK
Nair
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D005260:Female; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011859:Radiography; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D020217:Vertebral Artery Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D014859:Warfarin