Case Report Internal Carotid Artery Dissection Presenting as Isolated Hypoglossal Nerve Palsy – A Case Report

Hypoglossal palsy in carotid dissection

Authors

  • Admin https://orcid.org/0000-0003-2123-2524
  • Rakesh K Singh Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

DOI:

https://doi.org/10.15713/ins.bhj.167

Keywords:

Carotid dissection, Hypoglossal nerve palsy, Treatment of dissection

Abstract

As compared to other cranial nerves, hypoglossal nerve palsy is rare; and is often associated with other lower cranial nerve
palsies. The most common causes of hypoglossal nerve palsies are tumors followed by trauma, stroke, surgery, infection, and
multiple sclerosis. We report a case of a 55-year-old male presenting with dysphagia, dysarthria, and difficult mastication. He
was diagnosed to have isolated hypoglossal nerve palsy secondary to compression by internal carotid artery dissection (ICAD).
He was treated conservatively with antiplatelets and showed improvement on a 6-month follow-up. ICAD is a dangerous entity
with possible endangering complications and hence recognition of it is critical for appropriate treatment and prevention of
possible complications. ICAD should be considered in differential diagnosis for isolated hypoglossal nerve palsy.

References

Stino AM, Smith BE, Temkit M, Reddy SN. Hypoglossal nerve

palsy: 245 cases. Muscle Nerve 2016;54:1050-4.

Schievink WI. Spontaneous dissection of the carotid and vertebral

arteries. N Engl J Med 2001;344:898-906.

Lee VH, Brown RD, Mandrekar JN, Mokri B. Incidence and

outcome of cervical artery dissection: A population-based study.

Neurology 2006;67:1809-12.

Campos-Herrera CR, Scaff M, Yamamoto FI, Conforto AB.

Spontaneous cervical artery dissection: An update on clinical and

diagnostic aspects. Arq Neuropsiquiatr 2008;66:922-7.

Jurkiewicz MT, Stein JM, Learned KO, Nasrallah IM, Loevner LA.

Hypoglossal nerve palsy due to carotid artery dissection: An

uncommon presentation of a common problem. Neuroradiol J

;32:123-6.

Sturzenegger M, Huber P, Sturzenegger M. Cranial nerve palsies

in spontaneous carotid artery dissection. J Neurol Neurosurg

Psychiatry 1993;56:1191-9.

Murakami Y, Oda K, Konno Y, Matsumoto Y, Saito K. Successfully

treated with endovascular therapy against lower cranial nerve

paresis caused by spontaneous dissection of the cervical internal

carotid artery: A case report. J Neuroendovasc Ther 2016;10:30-5.

Kidoguchi T, Fukui I, Abe H, Mori K, Tamase A, Yamashita R,

et al. Carotid artery stenting for spontaneous internal carotid

artery dissection presenting with hypoglossal nerve palsy: A case

report. Surg Neurol Int 2022;13:225.

Markus HS, Levi C, King A, Madigan J, Norris J. Antiplatelet

therapy vs anticoagulation therapy in cervical artery dissection:

The cervical artery dissection in stroke study (cadiss) randomized

clinical trial final results. JAMA Neurol 2019;76:657-64.

Zeleňák K, Zeleňáková J, DeRiggo J, Kurča E, Kantorová E,

Poláček H. Treatment of cervical internal carotid artery

spontaneous dissection with pseudoaneurysm and unilateral

lower cranial nerves palsy by two silk flow diverters. Cardiovasc

Intervent Radiol 2013;36:1147-50.

Downloads

Published

16-09-2024

How to Cite

Admin, & Singh, R. k. (2024). Case Report Internal Carotid Artery Dissection Presenting as Isolated Hypoglossal Nerve Palsy – A Case Report: Hypoglossal palsy in carotid dissection. Bombay Hospital Journal, 65(4). https://doi.org/10.15713/ins.bhj.167