A Rare Case of Isolated Unilateral 12th Nerve Palsy due to Vertebral Artery Dissection

Dr. K.S. Sindhya, PG (Medicine), Dr. Nasreen Begum, MD, Dr. Balasubramaniyan Bhoopathy, MD, Dr. Varun Dhara, PG (Medicine)

Shri Sathya Sai Medical College and research Institute, Sembakkam, Chengalpattu District, Ammapetta, India-603108

*Corresponding Author: K.S. Sindhya, Shri Sathya Sai Medical College and research Institute, Sembakkam, Chengalpattu District, Ammapetta, India 603108, Email: sindhya.ppk@gmail.com

Citation: Sindhya KS (2020) A Rare Case of Isolated Unilateral 12th Nerve Palsy due to Vertebral Artery Dissection. Med Healthcare Rep, 2(2);1-4

Copyright: Â© 2020, K.S. Sindhya, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

INTRODUCTION

Isolated hypoglossal nerve palsy is rare due to its complex course and close proximity to other cranial nerves and vessels. It also represents a diagnostic challenge in every day clinical practice due to its diverse etiologies. There have been many published single case reports on isolated unilateral hypoglossal nerve involvement but case series are sparse in neurological literature. Till date there have been only two published case series on this subject, one including four patients and another nine patients. Keane et al. published his personal experience of 26 years on hypoglossal nerve palsy in 100 patients with or without the involvement of other brain stem structures. Thus, it would be worthwhile to state that isolated and unilateral hypoglossal nerve palsy seems either extremely rare or under-reported. Present case series includes 12 patients of isolated unilateral hypoglossal nerve palsy due to different etiologies, making it the largest case series till date, to the best of our knowledge [1-5].

Vertebral artery dissection (VAD) is a rare cause of stroke in the general population; however, represents one of the more common causes of stroke in patients younger than 45 years of age. Its signs and symptoms can be vague, and diagnosis can be elusive [6-8]. Spontaneous dissections have been reported. However, incidental minor trauma often precipitates this potentially dangerous condition. Often some neck distortion such as chiropractic manipulation, bending of the neck or blunt trauma causes the dissection. The dissection of the artery may ultimately lead to a stroke which often can be delayed for days following the acute dissection.

• Fulltext Article