Case report reveals symptom improvement following microvascular decompression in an adolescent with hypoglossal nerve palsy, highlighting vascular compression as a treatable cause.
BACKGROUND AND IMPORTANCE: Hypoglossal nerve palsy is an infrequent condition that could be rarely caused by compression from nearing vasculature. Hypoglossal nerve palsy associated with vertebral artery (VA) is rarely reported. There are less than 15 cases of such conditions in the literature. CLINICAL PRESENTATION: We present a 17-year-old boy suffering from dysarthria, chewing disability, a tingling sensation, and deviation of the tongue to the right from 6 months ago. After a thorough examination, MRI was performed with clinical suspicion of hypoglossal nerve palsy, and the result showed an ectatic VA pressing against the right hypoglossal nerve. He underwent microvascular decompression surgery. On follow-up visits, he showed gradual improvement of symptoms. CONCLUSION: In cases of cranial nerve palsies, compression by adjacent vasculature should be considered as a differential diagnosis and microvascular compression should be considered as a safe definitive treatment.
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Shafizadeh et al. (2022) studied this question.
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