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Twelfth-Nerve Palsy: Analysis of 100 Cases

Twelfth-Nerve Palsy: Analysis of 100 Cases Abstract Objective: To describe the causes and characteristics of hypoglossal nerve palsy. Design: A review of 26 years of personal experience in a large public hospital. Results: Twelfth-nerve palsies usually appear as signs rather than symptoms. Tumors, predominantly malignant, produced nearly half of the palsies (49 cases), while gunshot wounds made trauma (12) the second most common cause. Stroke (6), hysteria (6), multiple sclerosis (6), surgery (5), Guillain-Barré neuropathy (4), and infection (4) together accounted for about one third of the patients. Conclusion: Twelfth-nerve palsy proved to be an ominous sign, with only 15% of patients experiencing complete or nearly complete recovery. References 1. Erb W. Handbook of Electro-therapeutics . New York, NY: William Wood & Co; 1883:205. 2. Cushing H. The surgical treatment of facial paralysis by nerve anastomosis . Ann Surg . 1903;36:641-659. 3. Lowe AA. The neural regulation of tongue movements . Prog Neurobiol . 1981; 15:295-344.Crossref 4. Lowe AA. Tongue movements: brainstem mechanisms and clinical postulates . Brain Behav Evol . 1984;25:128-137.Crossref 5. Wilson JR, Sumner AJ, Eichelman J. Aberrant reinnervation following hypoglossal nerve damage . Muscle Nerve . 1994;17:931-935.Crossref 6. Wolf SM, Keane J, Feigenbaum J, Lu A. Myelopathy simulating spinal cord tumor . Bull L A Neurol Soc . 1975;40:131-139. 7. Keane JR. Tongue atrophy from brain-stem metastases . Arch Neurol . 1984; 41:1219-1220.Crossref 8. Bricol A, Turazzi S. Surgery for gliomas and other mass lesions of the brainstem . Adv Tech Stand Neurosurg . 1995;22:262-341. 9. Rubenstein MK. Cranial mononeuropathy as the first sign of intracranial metastases . Ann Intern Med . 1969;70:49-54.Crossref 10. Olsen ME, Chernik NL, Posner JB. Infiltration of the leptomeninges by systemic cancer: a clinical and pathologic study . Arch Neurol . 1974;30:122-137.Crossref 11. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients . Cancer . 1982; 49:759-772.Crossref 12. Little JR, Dale AJD, Okazakt H. Meningeal carcinomatosis: clinical manifestations . Arch Neurol . 1974;30:138-143.Crossref 13. Greenberg HS, Deck MDF, Vikram B, Chu FCH, Posner JB. Metastasis to the base of the skull: clinical findings in 43 patients . Neurology . 1981;31:530-537.Crossref 14. Godtfredsen E, Lederman M. Diagnostic and prognostic roles of ophthalmoneurologic signs and symptoms in malignant nasopharyngeal tumors . Am J Ophthalmol . 1965;59:1063-1069. 15. Hsu M-M, Tu S-M. Nasopharyngeal carcinoma in Taiwan: clinical manifestations and results of therapy . Cancer . 1983;52:362-368.Crossref 16. Lawley M. Nasopharyngeal carcinoma: an account of the cranial nerve lesions found in 185 cases . Aust NZJ Surg . 1956;25:170-178.Crossref 17. Strong MJ, Noseworthy JH. Hemiageusia, hemianaesthesia and hemiatrophy of the tongue . Can J Neurol Sci . 1986;13:109-110. 18. Dyste GN, Menezes AH, VanGilder JC. Symptomatic Chiari malformations: an analysis of presentation, management, and long-term outcome . J Neurosurg . 1989;71:159-168.Crossref 19. Saez RJ, Onofrio BM, Yanagihara T. Experience with Arnold-Chiari malformation, 1960-1970 . J Neurosurg . 1976;45:416-422.Crossref 20. Maniglia AJ, Han DP. Cranial nerve injuries following carotid endarterectomy: an analysis of 336 procedures . Head Neck . 1991;13:121-124.Crossref 21. Swift TR. Involvement of peripheral nerves in radical neck dissection . Am J Surg . 1970;119:694-698.Crossref 22. Smoker WRK. The hypoglossal nerve . Neuroimag Clin . 1993;3:193-206. 23. Mitchell SW. Injuries of the Nerves and Their Consequences . Philadelphia, Pa: JB Lippincott Co; 1872:335. 24. Purves-Stewart J, Evans A. Nerve Injuries and Their Treatment . 2nd ed. London, England: Henry Frowde; 1919. 25. Alrich EM, Baker GS. Injuries of the hypoglossal nerve: report of ten cases . Milit Surg . 1948;103:20-25. 26. Schoenberg BS, Massey EW. Tapia's syndrome: the erratic evolution of an eponym . Arch Neurol . 1979;36:257-260.Crossref 27. Messner AH, McGuirt WF, Blalock D. Bilateral hypoglossal nerve transection . Otolaryngol Head Neck Surg . 1995;112:329-332.Crossref 28. Keane JR. Locked-in syndrome after head and neck trauma . Neurology . 1985; 36:80-82.Crossref 29. Engelhardt P. Posttraumatische hypoglossusdiplegie . Nervenarzt . 1977;48:109-111. 30. Matthia P, Coudray C, Cornec, Leclec'h G, Bourdiniere J. Traumatisme cervical indirect et paralysie des deux dernieres paires craniennes: a propos de deux observations . Rev Otoneuroophtalmol . 1980;52:43-51. 31. Lindenberg R, Freytag E. Brainstem lesions characteristic of traumatic hyperextension of the head . Arch Pathol . 1970;90:509-515. 32. Berger PS, Battaini JP. Radiation-induced cranial nerve palsy . Cancer . 1977; 40:152-155.Crossref 33. Johnston EF, Hammond AJ, Cairncross JG. Bilateral hypoglossal palsies: a late complication of curative radiotherapy . Can J Neurol Sci . 1989;16:198-199. 34. Azizi SA, Fayad PB, Fulbright R, Giroux, Waxman SG. Clivus and cervical spinal osteomyelitis with epidural abscess presenting with multiple cranial neuropathies . Clin Neurol Neurosurg . 1995;97:239-244.Crossref 35. Malone DG, O'Boynick PL, Ziegler DK, Batnitzkyt S, Hubble JP, Holladay FP. Osteomyelitis of the skull base . Neuosurgery . 1992;30:426-431.Crossref 36. Thomas JE, Dinapoli RP. Neurologic aspects of malignant external otitis: report of three cases . Mayo Clin Proc . 1971;46:339-344. 37. Faden A. Neurological sequelae of malignant external otitis . Arch Neurol . 1975; 32:204-205.Crossref 38. Carpenter RR, Petersdorf RG. The clinical spectrum of bacterial meningitis . Am J Med . 1962;33:262-275.Crossref 39. Merritt HH, Adams RD, Solomon HC. Neurosyphilis . New York, NY: Oxford University Press; 1946:39. 40. Jackson JH. Case report 1867-68 . Clin Lectures Rep by the Med Surg Staff London Hosp . 1867-1868;4:314-317. 41. Engler CW, Missal SC. Involvement of the cranial nerves in poliomyelitis . Trans Am Acad Otolarygol Ophthalmol . 1955;59:732-739. 42. Jackson JH. On a case of paralysis of the tongue from haemorrhage in the medulla oblongata . Lancet . 1872;2:770-773.Crossref 43. Keane JR, Itabashi HH. Upbeat nystagmus: clinicopathological study of two patients . Neurology . 1987;37:491-494.Crossref 44. Kim JS, Kim HG, Chung CS. Medial medullary syndrome: report of 18 new patients and a review of the literature . Stroke . 1995;26:1548-1552.Crossref 45. Mokri B, Silbert PL, Shievink WI, Piepgras DG. Cranial nerve palsy in spontaneous dissection of the extracranial internal carotid artery . Neurology . 1996; 46:356-359.Crossref 46. Farrell FW, Ellenberger C Jr. Transient hemilingual paralysis: selective compression of the twelfth nerve and jugular bulb by a saccular carotid aneurysm . Neurology . 1972;22:1061-1064.Crossref 47. Nusynowitz RN, Stricof DD. Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis . Neuroradiology . 1990;32:229-231.Crossref 48. Keane JR. Wrong-way deviation of the tongue with hysterical hemiparesis . Neurology . 1986;36:1406-1407.Crossref 49. DeSimone PA, Snyder D. Hypoglossal nerve palsy in infectious mononucleosis . Neurology . 1978;28:844-847.Crossref 50. Afifi AK, Rifai ZH, Faris KB. Isolated, reversible, hypoglossal nerve palsy . Arch Neurol . 1984;41:1218.Crossref 51. Lee SS, Wang SJ, Fuh JL, Ltu HC. Transient unilateral hypoglossal nerve palsy: a case report . Clin Neurol Neurosurg . 1994;96:148-151.Crossref 52. Berthier E, Vighetto A, Aimard G, Confavreux C, Trillet M. Polyneuropathies craniennes idiopathiques . Rev Neurol . 1992;148:20-23. 53. Eshbaugh CG, Siatkowski RM, Smith JL, Kline LB. Simultaneous, multiple cranial neuropathies in diabetes mellitus . J Neuroophthalmol . 1995;15:219-224.Crossref 54. Symonds C. Recurrent multiple nerve palsies: a distinctive syndrome of cranial polyneuropathy . J Neurol Neurosurg Psychiatry . 1954;21:95-110.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Twelfth-Nerve Palsy: Analysis of 100 Cases

Keane, James R.
Archives of Neurology , Volume 53 (6) – Jun 1, 1996
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References (63)

Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1996.00550060105023
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Abstract

Abstract Objective: To describe the causes and characteristics of hypoglossal nerve palsy. Design: A review of 26 years of personal experience in a large public hospital. Results: Twelfth-nerve palsies usually appear as signs rather than symptoms. Tumors, predominantly malignant, produced nearly half of the palsies (49 cases), while gunshot wounds made trauma (12) the second most common cause. Stroke (6), hysteria (6), multiple sclerosis (6), surgery (5), Guillain-Barré neuropathy (4), and infection (4) together accounted for about one third of the patients. Conclusion: Twelfth-nerve palsy proved to be an ominous sign, with only 15% of patients experiencing complete or nearly complete recovery. References 1. Erb W. Handbook of Electro-therapeutics . New York, NY: William Wood & Co; 1883:205. 2. Cushing H. The surgical treatment of facial paralysis by nerve anastomosis . Ann Surg . 1903;36:641-659. 3. Lowe AA. The neural regulation of tongue movements . Prog Neurobiol . 1981; 15:295-344.Crossref 4. Lowe AA. Tongue movements: brainstem mechanisms and clinical postulates . Brain Behav Evol . 1984;25:128-137.Crossref 5. Wilson JR, Sumner AJ, Eichelman J. Aberrant reinnervation following hypoglossal nerve damage . Muscle Nerve . 1994;17:931-935.Crossref 6. Wolf SM, Keane J, Feigenbaum J, Lu A. Myelopathy simulating spinal cord tumor . Bull L A Neurol Soc . 1975;40:131-139. 7. Keane JR. Tongue atrophy from brain-stem metastases . Arch Neurol . 1984; 41:1219-1220.Crossref 8. Bricol A, Turazzi S. Surgery for gliomas and other mass lesions of the brainstem . Adv Tech Stand Neurosurg . 1995;22:262-341. 9. Rubenstein MK. Cranial mononeuropathy as the first sign of intracranial metastases . Ann Intern Med . 1969;70:49-54.Crossref 10. Olsen ME, Chernik NL, Posner JB. Infiltration of the leptomeninges by systemic cancer: a clinical and pathologic study . Arch Neurol . 1974;30:122-137.Crossref 11. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients . Cancer . 1982; 49:759-772.Crossref 12. Little JR, Dale AJD, Okazakt H. Meningeal carcinomatosis: clinical manifestations . Arch Neurol . 1974;30:138-143.Crossref 13. Greenberg HS, Deck MDF, Vikram B, Chu FCH, Posner JB. Metastasis to the base of the skull: clinical findings in 43 patients . Neurology . 1981;31:530-537.Crossref 14. Godtfredsen E, Lederman M. Diagnostic and prognostic roles of ophthalmoneurologic signs and symptoms in malignant nasopharyngeal tumors . Am J Ophthalmol . 1965;59:1063-1069. 15. Hsu M-M, Tu S-M. Nasopharyngeal carcinoma in Taiwan: clinical manifestations and results of therapy . Cancer . 1983;52:362-368.Crossref 16. Lawley M. Nasopharyngeal carcinoma: an account of the cranial nerve lesions found in 185 cases . Aust NZJ Surg . 1956;25:170-178.Crossref 17. Strong MJ, Noseworthy JH. Hemiageusia, hemianaesthesia and hemiatrophy of the tongue . Can J Neurol Sci . 1986;13:109-110. 18. Dyste GN, Menezes AH, VanGilder JC. Symptomatic Chiari malformations: an analysis of presentation, management, and long-term outcome . J Neurosurg . 1989;71:159-168.Crossref 19. Saez RJ, Onofrio BM, Yanagihara T. Experience with Arnold-Chiari malformation, 1960-1970 . J Neurosurg . 1976;45:416-422.Crossref 20. Maniglia AJ, Han DP. Cranial nerve injuries following carotid endarterectomy: an analysis of 336 procedures . Head Neck . 1991;13:121-124.Crossref 21. Swift TR. Involvement of peripheral nerves in radical neck dissection . Am J Surg . 1970;119:694-698.Crossref 22. Smoker WRK. The hypoglossal nerve . Neuroimag Clin . 1993;3:193-206. 23. Mitchell SW. Injuries of the Nerves and Their Consequences . Philadelphia, Pa: JB Lippincott Co; 1872:335. 24. Purves-Stewart J, Evans A. Nerve Injuries and Their Treatment . 2nd ed. London, England: Henry Frowde; 1919. 25. Alrich EM, Baker GS. Injuries of the hypoglossal nerve: report of ten cases . Milit Surg . 1948;103:20-25. 26. Schoenberg BS, Massey EW. Tapia's syndrome: the erratic evolution of an eponym . Arch Neurol . 1979;36:257-260.Crossref 27. Messner AH, McGuirt WF, Blalock D. Bilateral hypoglossal nerve transection . Otolaryngol Head Neck Surg . 1995;112:329-332.Crossref 28. Keane JR. Locked-in syndrome after head and neck trauma . Neurology . 1985; 36:80-82.Crossref 29. Engelhardt P. Posttraumatische hypoglossusdiplegie . Nervenarzt . 1977;48:109-111. 30. Matthia P, Coudray C, Cornec, Leclec'h G, Bourdiniere J. Traumatisme cervical indirect et paralysie des deux dernieres paires craniennes: a propos de deux observations . Rev Otoneuroophtalmol . 1980;52:43-51. 31. Lindenberg R, Freytag E. Brainstem lesions characteristic of traumatic hyperextension of the head . Arch Pathol . 1970;90:509-515. 32. Berger PS, Battaini JP. Radiation-induced cranial nerve palsy . Cancer . 1977; 40:152-155.Crossref 33. Johnston EF, Hammond AJ, Cairncross JG. Bilateral hypoglossal palsies: a late complication of curative radiotherapy . Can J Neurol Sci . 1989;16:198-199. 34. Azizi SA, Fayad PB, Fulbright R, Giroux, Waxman SG. Clivus and cervical spinal osteomyelitis with epidural abscess presenting with multiple cranial neuropathies . Clin Neurol Neurosurg . 1995;97:239-244.Crossref 35. Malone DG, O'Boynick PL, Ziegler DK, Batnitzkyt S, Hubble JP, Holladay FP. Osteomyelitis of the skull base . Neuosurgery . 1992;30:426-431.Crossref 36. Thomas JE, Dinapoli RP. Neurologic aspects of malignant external otitis: report of three cases . Mayo Clin Proc . 1971;46:339-344. 37. Faden A. Neurological sequelae of malignant external otitis . Arch Neurol . 1975; 32:204-205.Crossref 38. Carpenter RR, Petersdorf RG. The clinical spectrum of bacterial meningitis . Am J Med . 1962;33:262-275.Crossref 39. Merritt HH, Adams RD, Solomon HC. Neurosyphilis . New York, NY: Oxford University Press; 1946:39. 40. Jackson JH. Case report 1867-68 . Clin Lectures Rep by the Med Surg Staff London Hosp . 1867-1868;4:314-317. 41. Engler CW, Missal SC. Involvement of the cranial nerves in poliomyelitis . Trans Am Acad Otolarygol Ophthalmol . 1955;59:732-739. 42. Jackson JH. On a case of paralysis of the tongue from haemorrhage in the medulla oblongata . Lancet . 1872;2:770-773.Crossref 43. Keane JR, Itabashi HH. Upbeat nystagmus: clinicopathological study of two patients . Neurology . 1987;37:491-494.Crossref 44. Kim JS, Kim HG, Chung CS. Medial medullary syndrome: report of 18 new patients and a review of the literature . Stroke . 1995;26:1548-1552.Crossref 45. Mokri B, Silbert PL, Shievink WI, Piepgras DG. Cranial nerve palsy in spontaneous dissection of the extracranial internal carotid artery . Neurology . 1996; 46:356-359.Crossref 46. Farrell FW, Ellenberger C Jr. Transient hemilingual paralysis: selective compression of the twelfth nerve and jugular bulb by a saccular carotid aneurysm . Neurology . 1972;22:1061-1064.Crossref 47. Nusynowitz RN, Stricof DD. Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis . Neuroradiology . 1990;32:229-231.Crossref 48. Keane JR. Wrong-way deviation of the tongue with hysterical hemiparesis . Neurology . 1986;36:1406-1407.Crossref 49. DeSimone PA, Snyder D. Hypoglossal nerve palsy in infectious mononucleosis . Neurology . 1978;28:844-847.Crossref 50. Afifi AK, Rifai ZH, Faris KB. Isolated, reversible, hypoglossal nerve palsy . Arch Neurol . 1984;41:1218.Crossref 51. Lee SS, Wang SJ, Fuh JL, Ltu HC. Transient unilateral hypoglossal nerve palsy: a case report . Clin Neurol Neurosurg . 1994;96:148-151.Crossref 52. Berthier E, Vighetto A, Aimard G, Confavreux C, Trillet M. Polyneuropathies craniennes idiopathiques . Rev Neurol . 1992;148:20-23. 53. Eshbaugh CG, Siatkowski RM, Smith JL, Kline LB. Simultaneous, multiple cranial neuropathies in diabetes mellitus . J Neuroophthalmol . 1995;15:219-224.Crossref 54. Symonds C. Recurrent multiple nerve palsies: a distinctive syndrome of cranial polyneuropathy . J Neurol Neurosurg Psychiatry . 1954;21:95-110.Crossref

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Archives of Neurology – American Medical Association

Published: Jun 1, 1996

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