Hypoglossal nerve palsy is a common finding in neurological diseases when associated with other cranial nerve palsy or further pathology. The underlying pathology of its occurrence is very diverse. Keane analysed 100 cases of hypoglossal nerve palsy and found that most of them were caused by tumours. Different common causes were trauma, medullary infarctions, multiple sclerosis, Guillain–Barré neuropathy and infection.1 In contrast, isolated hypoglossal nerve palsy is a rare feature.

In general, hypoglossal nerve palsy, like other more common causes of neurogenic denervation, leads to atrophy of the affected muscle.2 However, some cases of motor denervation induce …