Isolated unilateral hypoglossal nerve palsy (HNP) is uncommon with only a few casereports and two case series in literature. Our study is the largest case series including12 patients. Till date isolated HNP was considered an ominous clinical sign indicatingan underlying malignancy, however ,in the present case series treatable causessuch as tubercular central nervous system infection(33%)and idiopathic (25%) casesoverweighed the neoplastic (16%) etiology. Sarcoidosis (8%), atlanto occipital dislocation(8%) and aberrant ectatic vessel in the hypoglossal canal (8%) were contributoryin the remaining cases.60% of the patients had a significant clinical recovery duringfollow up. The present study emphasizes that isolated HNP does not always herald agrave prognosis and an extensive diagnostic workup in these cases may yield commonand potentially treatable etiologies.
Bhawna Sharma, Parul Dubey, Sudhir Kumar, Ashok Panagariya, Amit Dev