Unilateral Hypoglossal Nerve Palsy: As the Only Presentation of Tuberculosis
Abstract
Tuberculous spondylitis is not an uncommon disease of the spine. Near one percent of all cases of spinal tuberculosis (TB) involves craniocervical junction. Hypoglossal nerve palsy is not an uncommon neurological finding, but isolated involvement of the hypoglossal nerve is rare and limited to case reports or small case series. Here, we report a case of craniocervical junction tuberculosis presenting with unilateral hypoglossal nerve palsy. Case is a 41-year-old woman with neck and suboccipital pain since one month and unilateral right hypoglossal nerve palsy since one week. All laboratory tests were unremarkable except raised ESR level. Involvement of C1-C2 and hypoglossal canal were demonstrated by CT scan of craniocervical junction. Tissue diagnosis of TB was established by open biopsy of the craniocervical junction.
Lee DK, Cho KT, Im SH, Hong SK. Craniovertebral junction tuberculosis with atlantoaxial dislocation: a case report and review of the literature. J Korean Neurosurg Soc 2007;42(5):406-9.
Bhojraj SY, Shetty N, Shah PJ. Tuberculosis of thecraniocervical junction. J Bone Joint Surg Br 2001;83(2):222-5.
Combarros O, Alvarez de Arcaya A, Berciano J. Isolated unilateral hypoglossal nerve palsy: nine cases. J Neurol 1998;245(2):98-100.
Boban M, Brinar VV, Habek M, Rados M. Isolated hypoglossal nerve palsy: a diagnostic challenge. Eur Neurol 2007;58(3):177-81.
Keane JR. Twelfth-nerve palsy. Analysis of 100 cases. Arch Neurol 1996;53(6):561-6.
Hadjikoutis S, Jayawant S, Stoodley N. Isolated hypoglossal nerve palsy in a 14-year-old girl. Eur J Paediatr Neurol 2002;6(4):225-8.
Mohindra S, Gupta SK, Mohindra S, Gupta R. Unusual presentations of craniovertebral junction tuberculosis: a report of 2 cases and literature review. Surg Neurol 2006;66(1):94-9; discussion 99.
Kanaan IU, Ellis M, Safi T, Al Kawi MZ, Coates R. Craniocervical junction tuberculosis: a rare but dangerous disease. Surg Neurol 1999;51(1):21-5; discussion 26.
Shukla D, Mongia S, Devi BI, Chandramouli BA, Das BS. Management of craniovertebral junction tuberculosis. Surg Neurol 2005;63(2):101-6; discussion 106.
Richards IM, White AM, O'Sullivan MM, Jessop JD, Williams BD. Unilateral palsy of the hypoglossal nerve in a patient with tuberculosis of the first cervical vertebra. Br J Rheumatol 1989;28(6):540-2.
Chakraborty PP. Deviated tongue: the presenting manifestation of spinal tuberculosis. Indian J Pediatr 2009;76(9):967-9.
| Files | ||
| Issue | Vol 50, No 10 (2012) | |
| Section | Original Article(s) | |
| Keywords | ||
| Craniocervical junction (CCJ) Hypoglossal nerve TB | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
