A rare neurological presentation of Ebstein-Barr virus: Isolated hypoglossal nerve palsy in a child

The isolated unilateral hypoglossal nerve palsy (HNP) is an unfamiliar clinical sign since it is rarely involved in isolation without the simultaneous involvement of other cranial nerves. It warrants a detailed history and clinical assessment. Neurologic manifestations are infrequent in infectious mononucleosis and especially hypoglossal nerve involvement is uncommon in daily practice. We report a 13-year-old girl who complained of deviation of the tongue to one side, trouble pronouncing linguals and difficulty chewing and swallowing with serologic evidence of active Epstein-Barr virus (EBV) infection. She developed transient isolated unilateral HNP manifests as parapharyngeal inflammation. Rarity and evaluation of isolated HNP pay particular attention in the pediatric field. Although HNP is an unusual neurologic complication of EBV, it should be considered in the differential diagnosis in the early evaluation of children.