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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Hypoglossal nerve (CNXII) palsy, hypoglossal nerve paralysis, tongue denervation/paralysis
Definitions
- Loss of nerve supply to tongue muscles
- Note: Palatoglossus muscle supplied by CNX
- Loss of nerve supply to tongue muscles
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Kim SY et al: Neuroanatomy, cranial nerve 12 (hypoglossal). StatPearls, 2021
- Di Pascuale I et al: Hypoglossal nerve schwannoma: case report and literature review. World Neurosurg. 135:205-8, 2020
- Guarnizo A et al: Imaging features of isolated hypoglossal nerve palsy. J Neuroradiol. 47(2):136-50, 2020
- Lee SH et al: Irreversible hypoglossal nerve injury and concomitant trigeminal system dysfunction after anterior surgery to the cervical spine: case report and literature review. World Neurosurg. 136:187-92, 2020
- Sawamura M et al: Unilateral hypoglossal nerve palsy: a hidden tumor. Intern Med. 59(4):587-88, 2020
- Chan TLH et al: Hypoglossal nerve palsy following chiropractic neck manipulation. Can J Neurol Sci. 46(5):633-4, 2019
- Chow JCH et al: Radiation-induced hypoglossal nerve palsy after definitive radiotherapy for nasopharyngeal carcinoma: Clinical predictors and dose-toxicity relationship. Radiother Oncol. 138:93-8, 2019
- Öztop-Çakmak Ö et al: Isolated hypoglossal nerve palsy due to a jugular foramen schwannoma. Ideggyogy Sz. 72(7-8):282-4, 2019
- Herath HMMTB et al: Tongue fasciculations with denervation pattern in osmotic demyelination syndrome: a case report of diagnostic dilemma. BMC Res Notes. 11(1):177, 2018
- Iaconetta G et al: The hypoglossal nerve: anatomical study of its entire course. World Neurosurg. 109:e486-92, 2018
- Ames CP et al: Hypoglossal nerve palsy after cervical spine surgery. Global Spine J. 7(1 Suppl):37S-9S, 2017
- Wee HE et al: Diagnostic pitfall: adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review. Int J Surg Case Rep. 25:102-5, 2016
- Al-Thunyan A et al: Hemi-hypoglossal nerve transfer for obstetric brachial plexus palsy: report of 3 cases. J Hand Surg Am. 40(3):448-51, 2015
- Exarchos ST et al: Hypoglossal paresis as the only complication of malignant otitis externa. B-ENT. 11(3):235-8, 2015
- Ilardi A et al: Persistent idiopathic hypoglossal nerve palsy: a motor neuron disease-mimic syndrome? Amyotroph Lateral Scler Frontotemporal Degener. 16(3-4):274-6, 2015
- Naik VD et al: A rare combination of facial and hypoglossal nerve palsies following post-traumatic internal carotid artery dissection. BMJ Case Rep. 2015, 2015
- Shah AC et al: Hypoglossal nerve palsy after airway management for general anesthesia: an analysis of 69 patients. Anesth Analg. 120(1):105-20, 2015
- Sin WY et al: Intracranial plasmacytoma with hypoglossal nerve palsy in multiple myeloma. Postgrad Med J. 91(1073):174-5, 2015
- Timbang MR et al: Hypoglossal nerve paralysis results in hypermetabolic activity on positron emission tomography/computed tomography in the contralateral tongue. Laryngoscope. 125(6):1382-4, 2015
- Ahmed SV et al: Isolated unilateral idiopathic transient hypoglossal nerve palsy. BMJ Case Rep. 2014, 2014
- Bensoussan Y et al: Atypical presentation of Eagle syndrome with hypoglossal nerve palsy and Horner syndrome. Head Neck. 36(12):E136-8, 2014
- Chen YG et al: Isolated hypoglossal nerve paralysis. Am J Med. 127(10):926-7, 2014
- Delrosso LM et al: Two-year-old with post-surgical hypoglossal nerve injury and obstructive sleep apnea. J Clin Sleep Med. 10(1):97-8, 2014
- Fujii H et al: Isolated unilateral hypoglossal nerve paralysis caused by internal carotid artery dissection. J Stroke Cerebrovasc Dis. 23(8):e405-6, 2014
- Jaganathan S et al: Hypoglossal nerve palsy: a rare consequence of dengue fever. Neurol India. 62(5):567-8, 2014
- Li X et al: Lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy. Neurol Sci. 35(4):633-4, 2014
- Patro SN et al: An unusual case of isolated hypoglossal nerve palsy secondary to osteophytic projection from the atlanto-occipital joint. Neuroradiol J. 27(3):361-4, 2014
- Rockholt M et al: Images in clinical medicine. Hypoglossal nerve palsy during meningococcal meningitis. N Engl J Med. 371(15):e22, 2014
- Ferlazzo E et al: Isolated hypoglossal nerve palsy due to spontaneous carotid artery dissection: a neuroimaging study. Neurol Sci. 34(11):2043-4, 2013
- Kapoor S: Collet-Sicard syndrome: a rare cause of hypoglossal nerve palsy. J Laryngol Otol. 127(10):1040, 2013
- Kasfiki EV et al: Skull base osteomyelitis presenting with an isolated hypoglossal nerve palsy. BMJ Case Rep. 2013, 2013
- Riancho J et al: Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection. J Neurol Neurosurg Psychiatry. 84(6):706, 2013
- Shikino K et al: Transient idiopathic isolated unilateral hypoglossal nerve palsy. J Gen Intern Med. 28(4):591, 2013
- De Santis F et al: Internal carotid artery dissection after inferior alveolar nerve block for third molar dental care presented as hypoglossal nerve palsy. Vasc Endovascular Surg. 46(7):591-5, 2012
- Ebadi H et al: Unilateral hypoglossal nerve palsy: as the only presentation of tuberculosis. Acta Med Iran. 50(10):717-20, 2012
- Epstein E et al: Carotid artery dissection causing hypoglossal nerve palsy. BMJ Case Rep. 2012, 2012
- Femia G et al: Isolated reversible hypoglossal nerve palsy as the initial manifestation of pre-eclampsia. J Clin Neurosci. 19(4):602-3, 2012
- Learned KO et al: Hypoglossal nerve palsy missed and misinterpreted: the hidden skull base. J Comput Assist Tomogr. 36(6):718-24, 2012
- Okunomiya T et al: Teaching NeuroImages: isolated hypoglossal nerve palsy due to internal carotid artery dissection. Neurology. 79(4):e37, 2012
- Renard D et al: Mystery case: hypoglossal nerve palsy in occipito-temporal pneumatization. Neurology. 79(13):e109-10, 2012
- Stich O et al: Hypoglossal nerve palsy after extensive vomiting. J Clin Neurosci. 19(5):744, 776-7, 2012
- Mendelsohn D et al: Isolated unilateral hypoglossal nerve palsy. Can J Neurol Sci. 38(5):796-7, 2011
- Yamamoto M et al: Isolated hypoglossal nerve palsy caused by neurovascular compression. Intern Med. 50(21):2701-2, 2011
- Alves P: Imaging the hypoglossal nerve. Eur J Radiol. 74(2):368-77, 2010
- Mendes-Araujo L et al: Case report. Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis. Br J Radiol. 83(986):e35-8, 2010
- Holle D et al: Neurological picture. Tongue pseudohypertrophy in idiopathic hypoglossal nerve palsy. J Neurol Neurosurg Psychiatry. 80(12):1393, 2009
- Hui AC et al: Hypoglossal nerve palsy. Hong Kong Med J. 15(3):234, 2009
- Lin HC et al: Cranial nerve XII: the hypoglossal nerve. Semin Neurol. 29(1):45-52, 2009
- Lopes G et al: Two cases of isolated unilateral paralysis of hypoglossal nerve after uncomplicated orotracheal intubation. Acta Anaesthesiol Belg. 60(3):191-3, 2009
- Marin LF et al: Hypoglossal nerve palsy as the sole manifestation of spontaneous internal carotid artery dissection. Arq Neuropsiquiatr. 67(1):107-8, 2009
- Zeina AR et al: Hypoglossal nerve palsy secondary to cervical spine involvement in rheumatoid arthritis: clinical and radiological features. Joint Bone Spine. 76(5):547-9, 2009
- Billan S et al: Radiation-induced hypoglossal nerve palsy. Isr Med Assoc J. 9(2):134, 2007
- Graham RM et al: Isolated hypoglossal nerve palsy due to a vascular anomaly. Int J Oral Maxillofac Surg. 36(8):759-61, 2007
- Khoo SG et al: Isolated hypoglossal nerve palsy: a harbinger of malignancy. J Laryngol Otol. 121(8):803-5, 2007
- Chugh S et al: Occipital condyle fracture with associated hypoglossal nerve injury. Can J Neurol Sci. 33(3):322-4, 2006
- Hong JT et al: Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass. Case report. J Neurosurg Spine. 5(1):83-5, 2006
- Chien JT et al: Atlantoaxial rotatory dislocation with hypoglossal nerve palsy in a patient with ankylosing spondylitis. A case report. J Bone Joint Surg Am. 87(7):1587-90, 2005
- Zafeiriou DI et al: Images in clinical medicine. Hypoglossal-nerve palsy. N Engl J Med. 350(5):e4, 2004
- Lindsay FW et al: Subacute hypoglossal nerve paresis with internal carotid artery dissection. Laryngoscope. 113(9):1530-3, 2003
- Kaushik V et al: Isolated unilateral hypoglossal nerve palsy after minor head trauma. Clin Neurol Neurosurg. 105(1):42-7, 2002
- Loh C et al: Cranial nerve XII: the hypoglossal nerve. Semin Ultrasound CT MR. 23(3):256-65, 2002
- Pavithran K et al: Isolated hypoglossal nerve palsy due to skull base metastasis from breast cancer. Australas Radiol. 45(4):534-5, 2001
- King AD et al: MR features of the denervated tongue in radiation induced neuropathy. Br J Radiol. 72(856):349-53, 1999
- Murakami R et al: MR of denervated tongue: temporal changes after radical neck dissection. AJNR Am J Neuroradiol. 19(3):515-8, 1998
- Batchelor TT et al: Neuroimaging abnormalities with hypoglossal nerve palsies. J Neuroimaging. 7(2):86-8, 1997
- Murakami R et al: CT and MR findings of denervated tongue after radical neck dissection. AJNR Am J Neuroradiol. 18(4):747-50, 1997
- Russo CP et al: MR appearance of trigeminal and hypoglossal motor denervation. AJNR Am J Neuroradiol. 18(7):1375-83, 1997
- Harnsberger HR et al: Major motor atrophic patterns in the face and neck: CT evaluation. Radiology. 155(3):665-70, 1985
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Hypoglossal nerve (CNXII) palsy, hypoglossal nerve paralysis, tongue denervation/paralysis
Definitions
- Loss of nerve supply to tongue muscles
- Note: Palatoglossus muscle supplied by CNX
- Loss of nerve supply to tongue muscles
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Kim SY et al: Neuroanatomy, cranial nerve 12 (hypoglossal). StatPearls, 2021
- Di Pascuale I et al: Hypoglossal nerve schwannoma: case report and literature review. World Neurosurg. 135:205-8, 2020
- Guarnizo A et al: Imaging features of isolated hypoglossal nerve palsy. J Neuroradiol. 47(2):136-50, 2020
- Lee SH et al: Irreversible hypoglossal nerve injury and concomitant trigeminal system dysfunction after anterior surgery to the cervical spine: case report and literature review. World Neurosurg. 136:187-92, 2020
- Sawamura M et al: Unilateral hypoglossal nerve palsy: a hidden tumor. Intern Med. 59(4):587-88, 2020
- Chan TLH et al: Hypoglossal nerve palsy following chiropractic neck manipulation. Can J Neurol Sci. 46(5):633-4, 2019
- Chow JCH et al: Radiation-induced hypoglossal nerve palsy after definitive radiotherapy for nasopharyngeal carcinoma: Clinical predictors and dose-toxicity relationship. Radiother Oncol. 138:93-8, 2019
- Öztop-Çakmak Ö et al: Isolated hypoglossal nerve palsy due to a jugular foramen schwannoma. Ideggyogy Sz. 72(7-8):282-4, 2019
- Herath HMMTB et al: Tongue fasciculations with denervation pattern in osmotic demyelination syndrome: a case report of diagnostic dilemma. BMC Res Notes. 11(1):177, 2018
- Iaconetta G et al: The hypoglossal nerve: anatomical study of its entire course. World Neurosurg. 109:e486-92, 2018
- Ames CP et al: Hypoglossal nerve palsy after cervical spine surgery. Global Spine J. 7(1 Suppl):37S-9S, 2017
- Wee HE et al: Diagnostic pitfall: adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review. Int J Surg Case Rep. 25:102-5, 2016
- Al-Thunyan A et al: Hemi-hypoglossal nerve transfer for obstetric brachial plexus palsy: report of 3 cases. J Hand Surg Am. 40(3):448-51, 2015
- Exarchos ST et al: Hypoglossal paresis as the only complication of malignant otitis externa. B-ENT. 11(3):235-8, 2015
- Ilardi A et al: Persistent idiopathic hypoglossal nerve palsy: a motor neuron disease-mimic syndrome? Amyotroph Lateral Scler Frontotemporal Degener. 16(3-4):274-6, 2015
- Naik VD et al: A rare combination of facial and hypoglossal nerve palsies following post-traumatic internal carotid artery dissection. BMJ Case Rep. 2015, 2015
- Shah AC et al: Hypoglossal nerve palsy after airway management for general anesthesia: an analysis of 69 patients. Anesth Analg. 120(1):105-20, 2015
- Sin WY et al: Intracranial plasmacytoma with hypoglossal nerve palsy in multiple myeloma. Postgrad Med J. 91(1073):174-5, 2015
- Timbang MR et al: Hypoglossal nerve paralysis results in hypermetabolic activity on positron emission tomography/computed tomography in the contralateral tongue. Laryngoscope. 125(6):1382-4, 2015
- Ahmed SV et al: Isolated unilateral idiopathic transient hypoglossal nerve palsy. BMJ Case Rep. 2014, 2014
- Bensoussan Y et al: Atypical presentation of Eagle syndrome with hypoglossal nerve palsy and Horner syndrome. Head Neck. 36(12):E136-8, 2014
- Chen YG et al: Isolated hypoglossal nerve paralysis. Am J Med. 127(10):926-7, 2014
- Delrosso LM et al: Two-year-old with post-surgical hypoglossal nerve injury and obstructive sleep apnea. J Clin Sleep Med. 10(1):97-8, 2014
- Fujii H et al: Isolated unilateral hypoglossal nerve paralysis caused by internal carotid artery dissection. J Stroke Cerebrovasc Dis. 23(8):e405-6, 2014
- Jaganathan S et al: Hypoglossal nerve palsy: a rare consequence of dengue fever. Neurol India. 62(5):567-8, 2014
- Li X et al: Lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy. Neurol Sci. 35(4):633-4, 2014
- Patro SN et al: An unusual case of isolated hypoglossal nerve palsy secondary to osteophytic projection from the atlanto-occipital joint. Neuroradiol J. 27(3):361-4, 2014
- Rockholt M et al: Images in clinical medicine. Hypoglossal nerve palsy during meningococcal meningitis. N Engl J Med. 371(15):e22, 2014
- Ferlazzo E et al: Isolated hypoglossal nerve palsy due to spontaneous carotid artery dissection: a neuroimaging study. Neurol Sci. 34(11):2043-4, 2013
- Kapoor S: Collet-Sicard syndrome: a rare cause of hypoglossal nerve palsy. J Laryngol Otol. 127(10):1040, 2013
- Kasfiki EV et al: Skull base osteomyelitis presenting with an isolated hypoglossal nerve palsy. BMJ Case Rep. 2013, 2013
- Riancho J et al: Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection. J Neurol Neurosurg Psychiatry. 84(6):706, 2013
- Shikino K et al: Transient idiopathic isolated unilateral hypoglossal nerve palsy. J Gen Intern Med. 28(4):591, 2013
- De Santis F et al: Internal carotid artery dissection after inferior alveolar nerve block for third molar dental care presented as hypoglossal nerve palsy. Vasc Endovascular Surg. 46(7):591-5, 2012
- Ebadi H et al: Unilateral hypoglossal nerve palsy: as the only presentation of tuberculosis. Acta Med Iran. 50(10):717-20, 2012
- Epstein E et al: Carotid artery dissection causing hypoglossal nerve palsy. BMJ Case Rep. 2012, 2012
- Femia G et al: Isolated reversible hypoglossal nerve palsy as the initial manifestation of pre-eclampsia. J Clin Neurosci. 19(4):602-3, 2012
- Learned KO et al: Hypoglossal nerve palsy missed and misinterpreted: the hidden skull base. J Comput Assist Tomogr. 36(6):718-24, 2012
- Okunomiya T et al: Teaching NeuroImages: isolated hypoglossal nerve palsy due to internal carotid artery dissection. Neurology. 79(4):e37, 2012
- Renard D et al: Mystery case: hypoglossal nerve palsy in occipito-temporal pneumatization. Neurology. 79(13):e109-10, 2012
- Stich O et al: Hypoglossal nerve palsy after extensive vomiting. J Clin Neurosci. 19(5):744, 776-7, 2012
- Mendelsohn D et al: Isolated unilateral hypoglossal nerve palsy. Can J Neurol Sci. 38(5):796-7, 2011
- Yamamoto M et al: Isolated hypoglossal nerve palsy caused by neurovascular compression. Intern Med. 50(21):2701-2, 2011
- Alves P: Imaging the hypoglossal nerve. Eur J Radiol. 74(2):368-77, 2010
- Mendes-Araujo L et al: Case report. Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis. Br J Radiol. 83(986):e35-8, 2010
- Holle D et al: Neurological picture. Tongue pseudohypertrophy in idiopathic hypoglossal nerve palsy. J Neurol Neurosurg Psychiatry. 80(12):1393, 2009
- Hui AC et al: Hypoglossal nerve palsy. Hong Kong Med J. 15(3):234, 2009
- Lin HC et al: Cranial nerve XII: the hypoglossal nerve. Semin Neurol. 29(1):45-52, 2009
- Lopes G et al: Two cases of isolated unilateral paralysis of hypoglossal nerve after uncomplicated orotracheal intubation. Acta Anaesthesiol Belg. 60(3):191-3, 2009
- Marin LF et al: Hypoglossal nerve palsy as the sole manifestation of spontaneous internal carotid artery dissection. Arq Neuropsiquiatr. 67(1):107-8, 2009
- Zeina AR et al: Hypoglossal nerve palsy secondary to cervical spine involvement in rheumatoid arthritis: clinical and radiological features. Joint Bone Spine. 76(5):547-9, 2009
- Billan S et al: Radiation-induced hypoglossal nerve palsy. Isr Med Assoc J. 9(2):134, 2007
- Graham RM et al: Isolated hypoglossal nerve palsy due to a vascular anomaly. Int J Oral Maxillofac Surg. 36(8):759-61, 2007
- Khoo SG et al: Isolated hypoglossal nerve palsy: a harbinger of malignancy. J Laryngol Otol. 121(8):803-5, 2007
- Chugh S et al: Occipital condyle fracture with associated hypoglossal nerve injury. Can J Neurol Sci. 33(3):322-4, 2006
- Hong JT et al: Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass. Case report. J Neurosurg Spine. 5(1):83-5, 2006
- Chien JT et al: Atlantoaxial rotatory dislocation with hypoglossal nerve palsy in a patient with ankylosing spondylitis. A case report. J Bone Joint Surg Am. 87(7):1587-90, 2005
- Zafeiriou DI et al: Images in clinical medicine. Hypoglossal-nerve palsy. N Engl J Med. 350(5):e4, 2004
- Lindsay FW et al: Subacute hypoglossal nerve paresis with internal carotid artery dissection. Laryngoscope. 113(9):1530-3, 2003
- Kaushik V et al: Isolated unilateral hypoglossal nerve palsy after minor head trauma. Clin Neurol Neurosurg. 105(1):42-7, 2002
- Loh C et al: Cranial nerve XII: the hypoglossal nerve. Semin Ultrasound CT MR. 23(3):256-65, 2002
- Pavithran K et al: Isolated hypoglossal nerve palsy due to skull base metastasis from breast cancer. Australas Radiol. 45(4):534-5, 2001
- King AD et al: MR features of the denervated tongue in radiation induced neuropathy. Br J Radiol. 72(856):349-53, 1999
- Murakami R et al: MR of denervated tongue: temporal changes after radical neck dissection. AJNR Am J Neuroradiol. 19(3):515-8, 1998
- Batchelor TT et al: Neuroimaging abnormalities with hypoglossal nerve palsies. J Neuroimaging. 7(2):86-8, 1997
- Murakami R et al: CT and MR findings of denervated tongue after radical neck dissection. AJNR Am J Neuroradiol. 18(4):747-50, 1997
- Russo CP et al: MR appearance of trigeminal and hypoglossal motor denervation. AJNR Am J Neuroradiol. 18(7):1375-83, 1997
- Harnsberger HR et al: Major motor atrophic patterns in the face and neck: CT evaluation. Radiology. 155(3):665-70, 1985
