Ahmed Syed Viqar, Akram Muhammad Saqub
Department of Acute Medicine, Stepping Hill Hospital, Stockport, UK.
BMJ Case Rep. 2014 Jun 26;2014:bcr2014203930. doi: 10.1136/bcr-2014-203930.
A 52-year-old Caucasian man presented with sudden onset of difficulty in moving his tongue to the left with preceding left-sided headache with no neck pain. Earlier, he had self-limiting chest infection without rashes or tonsillar enlargement. His medical and surgical history was unremarkable with no recent trauma. Oral examination revealed difficulty in protruding his tongue to the left with muscle bulk loss and fasciculation on the same side, suggesting left hypoglossal nerve palsy. Examination of the rest of the cranial nerves and nervous system was normal. The patient's oropharyngeal and laryngeal examination was unremarkable with no cervical lymphadenopathy. He had normal laboratory investigations and cerebrospinal fluid examination. Extensive imaging of the head, neck and chest failed to reveal any pathology. Further review by an otorhinologist and rheumatologist ruled out any other underlying pathology. He made a good recovery without treatment. English literature search revealed very few cases of idiopathic, transient, unilateral hypoglossal nerve palsy.
一名52岁的白种男性，出现向左伸舌突然困难，此前有左侧头痛，无颈部疼痛。早些时候，他曾患自限性胸部感染，无皮疹或扁桃体肿大。他的内科和外科病史无异常，近期无外伤史。口腔检查发现向左伸舌困难，同侧肌肉萎缩并伴有肌束震颤，提示左侧舌下神经麻痹。其余颅神经和神经系统检查正常。患者的口咽和喉部检查无异常，无颈部淋巴结肿大。他的实验室检查和脑脊液检查均正常。对头、颈和胸部进行的全面影像学检查未发现任何病变。耳鼻喉科医生和风湿病学家进一步检查排除了任何其他潜在病变。未经治疗，他恢复良好。英文文献检索显示，特发性、短暂性、单侧舌下神经麻痹的病例非常少。
