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Post viral unilateral isolated hypoglossal nerve palsy with cervical lymphadenitis: a case report

Background/objectives: Unilateral hypoglossal nerve palsy is not an uncommon finding in neurological diseases. It is a rare condition in childhood where the mononeuropathies of the facial nerve are the commonest reported.

Setting: Department of Head and Neck oncosurgery, Kidwai Memorial Institute of Oncology , Bangalore. Case report: A 12yr old boy was referred to our outpatient clinic with history of deviation of the tongue to the right and small enlarged lymph nodes in the right neck since 3 years.The deviation was seen after an episode of viral infection with rashes. Contrast enhanced CT and MRI scans were negative for any organic pathology. Excision biopsy revealed reactive lymphadenitis in the lymph nodes.

Conclusion: Isolated unilateral hypoglossal nerve palsy represents a formidable challenge and indepth patient history accompanied with good knowledge of hypoglossal nerve anatomy and a rational selection of diagnostic tests is necessary for making the diagnosis.

Author(s): Sudhir M Naik, Mahesh kalloli, Rajshekar Halkud , Purshottam Chavan, Sidappa KT5, Sunil KC, Jagdish S Sarvadyna