Isolated tubercular hypoglossal nerve paralysis

Hypoglossal nerve palsy is not an uncommon neurological finding but primary nasopharyngeal tuberculosis (TB) presenting as hypoglossal nerve palsy is very rare. A 31-year-old woman presented with headache and progressive tongue deviation towards the right side. Diagnostic nasal endoscopy revealed soft tissue mass lesion on the posterior wall of nasopharynx while MRI revealed isointense tumour in nasopharynx with normal hypoglossal nerve and brain. Histopathological examination found TB. We discuss the clinical challenges and possible pathogenesis of this rare clinical entity.

[1]  P. Sittitrai,et al.  Nasopharyngeal Tuberculosis: Epidemiology, Mechanism of Infection, Clinical Manifestations, and Management , 2016, International journal of otolaryngology.

[2]  P. Brennan,et al.  Corrigendum to “Persistent idiopathic unilateral hypoglossal nerve palsy: a case report” [Br. J. Oral Maxillofac. Surg. 52 (2014) 572–574] , 2015 .

[3]  P. Brennan,et al.  Persistent idiopathic unilateral hypoglossal [corrected] nerve palsy: a case report. , 2014, The British journal of oral & maxillofacial surgery.

[4]  S. V. Ahmed,et al.  Isolated unilateral idiopathic transient hypoglossal nerve palsy , 2014, BMJ Case Reports.

[5]  Chandrakant Patil,et al.  Primary tuberculosis of nasopharynx (adenoid)- a rare presentation. , 2013, Asian Pacific journal of tropical medicine.

[6]  H. Ebadi,et al.  Unilateral hypoglossal nerve palsy: as the only presentation of tuberculosis. , 2012, Acta medica Iranica.

[7]  B. Sharma,et al.  Isolated Unilateral Hypoglossal Nerve Palsy: A Study of 12 cases , 2011 .

[8]  L. Stassen,et al.  Idiopathic isolated unilateral hypoglossal nerve palsy: a diagnosis of exclusion. , 2008, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[9]  M. Radoš,et al.  Isolated Hypoglossal Nerve Palsy: A Diagnostic Challenge , 2007, European Neurology.

[10]  A. King,et al.  Tuberculosis of the Nasopharynx: A Rare Entity Revisited , 2003, The Laryngoscope.

[11]  A. King,et al.  MR imaging features of nasopharyngeal tuberculosis: report of three cases and literature review. , 2003, AJNR. American journal of neuroradiology.

[12]  J. Keane.  Twelfth-nerve palsy. Analysis of 100 cases. , 1996, Archives of neurology.

[13]  C. V. van Hasselt,et al.  Tuberculosis of the nasopharynx: clinicopathological features. , 1992, Clinical otolaryngology and allied sciences.

[14]  F. D. Martinson.  Primary Tuberculosis of the Nasopharynx in a Nigerian , 1967, The Journal of Laryngology & Otology.