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Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection
  1. Javier Riancho1,2,
  2. Jon Infante1,2,
  3. Jose Ignacio Mateo1,2,
  4. Jose Berciano1,2,
  5. Leire Agea3
  1. 1Services of Neurology, University Hospital “Marqués de Valdecilla” (IFIMAV), University of Cantabria, Santander, Spain
  2. 2“Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas” (CIBERNED), Santander, Spain
  3. 3Department of Endocrinology, University Hospital “Marqués de Valdecilla” (IFIMAV), University of Cantabria, Santander, Spain
  1. Correspondence to Dr Javier Riancho, Service of Neurology, University Hospital “Marqués de Valdecilla”, Av Valdecilla s/n, Santander 39008, Spain; jariancho{at}

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A 54-year-old healthy man was admitted to our hospital with acute dysarthria and mild impairment in swallowing and tongue movements, which he had noticed 2 days before. He was not taking any drugs, and his medical history was unremarkable except for mild hypertension (145/95 mm Hg). He denied prior trauma, fever, facial pain, headache or any other symptoms.

Physical examination showed mild dysarthria and left-sided tongue deviation when the patient poked his tongue out, which was consistent with left hypoglossal nerve palsy (figure 1A). Other cranial nerves were preserved. Carotid murmurs were not heard, and the general and neurological exams were otherwise normal.

Figure 1

(A) Patient's tongue. (B) T2-weighted cranial MRI image and MRI angiography (C) narrowing of the lumen …

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  • Contributors JR was involved in conception and writing of the manuscript. JI, JIM and JB were critically involved in revision of the manuscript. LA contributed towards obtaining clinical information.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.