Ann Rehabil Med.  2014 Oct;38(5):689-693. 10.5535/arm.2014.38.5.689.

Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

Affiliations
  • 1Department of Physical & Rehabilitation Medicine, Gachon University School of Medicine, Incheon, Korea. pmrdoc@gilhospital.com

Abstract

Occipital condyle fractures (OCFs) with selective involvement of the hypoglossal canal are rare. OCFs usually occur after major trauma and combine multiple fractures. We describe a 38-year-old man who presented with neck pain and a tongue deviation to the right side after a traffic accident. Severe limitations were detected during active and passive range of neck motion in all directions. A physical examination revealed a normal gag reflex and normal mobility of the palate, larynx, and shoulder girdle. He had normal taste and general sensation in his tongue. However, he presented with a tongue deviation to the right side on protrusion. A videofluoroscopic swallowing study revealed piecemeal deglutition due to decreased tongue mobility but no aspiration of food. Plain X-ray film findings were negative, but a computed tomography study with coronal reconstruction demonstrated a right OCF involving the hypoglossal canal. An electrodiagnostic study revealed evidence of right hypoglossal nerve palsy. We report a rare case of isolated hypoglossal nerve palsy caused by an OCF.

Keyword

Occipital condyle fracture; Hypoglossal nerve; Multidetector computed tomography; Electrodiagnosis

MeSH Terms

Accidents, Traffic
Adult
Deglutition
Electrodiagnosis
Humans
Hypoglossal Nerve
Hypoglossal Nerve Diseases*
Larynx
Multidetector Computed Tomography
Neck
Neck Pain
Palate
Physical Examination
Reflex
Sensation
Shoulder
Tongue
X-Ray Film
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