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Hypoglossal Nerve Disorders

By

Michael Rubin

, MDCM, New York Presbyterian Hospital-Cornell Medical Center

Last full review/revision Sep 2020| Content last modified Sep 2020
Click here for the Professional Version

Disorders of the 12th cranial nerve (hypoglossal nerve) cause weakness or wasting (atrophy) of the tongue on the affected side. This nerve moves the tongue.

  • Hypoglossal nerve disorders may be caused by tumors, strokes, infections, injuries, or amyotrophic lateral sclerosis.

  • People with hypoglossal nerve disorder have difficulty speaking, chewing, and swallowing.

  • Doctors usually do magnetic resonance imaging and/or a spinal tap to identify the cause.

  • The cause is treated.

Causes of Hypoglossal Nerve Disorders

Causes of hypoglossal nerve disorders include

  • A tumor or bone abnormality at the base of the skull

  • A bulge (aneurysm) in an artery at the base of the brain

  • A stroke

  • Infection of the brain stem

  • An injury to the neck, as may occur after surgical removal of a blockage from an artery in the neck (endarterectomy)

  • Amyotrophic lateral sclerosis (Lou Gehrig disease)

Symptoms of Hypoglossal Nerve Disorders

The tongue becomes weak on the affected side and eventually wastes away (atrophies). As a result, people have difficulty speaking, chewing, and swallowing. Damage due to amyotrophic lateral sclerosis causes tiny, subtle twitching movements (fasciculations) on the surface of the tongue.

Diagnosis of Hypoglossal Nerve Disorders

  • Magnetic resonance imaging

  • Sometimes a spinal tap

Magnetic resonance imaging (MRI) is usually done to look for a tumor or evidence of a stroke.

A spinal tap (lumbar puncture) may be necessary if cancer or infection is possible.

Treatment of Hypoglossal Nerve Disorders

  • Treatment of the cause

Treatment of hypoglossal nerve disorders depends on the cause.

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