ABSTRACT
Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal nerve can be a complication of anaesthetic airway management (Tapia's syndrome) or focal involvement due to Legionella infection. We present a patient with bilateral hypoglossal and unilateral recurrent laryngeal nerves palsy after a complicated intubation and a Legionella infection. Clarithromycin therapy was started. Within months, tongue mobility and swallowing gradually improved. Two months after discharge persisting unilateral recurrent nerve palsy was observed.
Subject(s)
Hypoglossal Nerve Diseases/microbiology , Intubation, Intratracheal/adverse effects , Legionnaires' Disease/complications , Tongue Diseases/microbiology , Vocal Cord Paralysis/microbiology , Humans , Hypoglossal Nerve Diseases/therapy , Legionella pneumophila , Legionnaires' Disease/therapy , Male , Middle Aged , Tongue Diseases/therapy , Vocal Cord Paralysis/therapySubject(s)
Hypoglossal Nerve Diseases/etiology , Retropharyngeal Abscess/complications , Tuberculosis/complications , Antitubercular Agents/administration & dosage , Child , Drainage/methods , Humans , Hypoglossal Nerve Diseases/microbiology , Isoniazid/administration & dosage , Magnetic Resonance Imaging/methods , Male , Mycobacterium tuberculosis , Retropharyngeal Abscess/drug therapy , Retropharyngeal Abscess/microbiology , Tongue , Tuberculosis/drug therapyABSTRACT
We report on a 30-year-old patient with isolated, left-sided hypoglossal nerve palsy after uncomplicated, presumably streptococci-induced tonsillitis. Needle electromyography (EMG) of the tongue showed denervation changes in the muscles supplied by the left hypoglossal nerve. Cranial CT and MRI, CSF examination, Doppler sonography, visual evoked potential (VEP), and auditory evoked potential (AEP) showed no abnormalities and, in particular, no signs of the carotid artery dissection or brainstem lesion. The symptoms and signs resolved within a few weeks after penicillin V treatment. We suppose that the hypoglossal affection of the uncomplicated tonsillitis in this case was due to an aberrant position of the nerve.