Isolated hypoglossal nerve palsy- A case report
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Innervation of the extrinsic and intrinsic muscles of the tongue, excluding only the palataoglossus, is from the twelfth cranial nerve. The hypoglossal nerve is primarily motor in function and controls tongue movement, meaning palsy of this nerve can result in altered movement and appearance of the tongue, with swallowing and speech difficulties. Hypoglossal nerve palsy usually presents with additional neurological symptoms, its presentation in isolation is rare. This was apparent following review of the literature which revealed mostly single cases in isolation and only a very limited selection of small case series having previously been published. We report an isolated unilateral hypoglossal nerve palsy in a 59-year-old gentleman. Following a thorough investigation, it became apparent that this was the first presentation of widespread metastasis. Our report emphasizes the importance of a systematic approach and investigation to rule out an underlying sinister cause.

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