Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: An uncommon neurovascular compression syndrome

• Published in: Journal of the neurological sciences Vol. 323; no. 1; pp. 248 - 249
• Main Authors: Meila, Dan, Wetter, Axel, Brassel, Friedhelm, Nacimiento, Wilhelm
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 15.12.2012; Elsevier
• Subjects: Aged; Angiography, Digital Subtraction; Arteries; Basilar Artery - abnormalities; Basilar Artery - diagnostic imaging; Basilar Artery - pathology; Biological and medical sciences; Calcinosis - complications; Calcinosis - diagnostic imaging; Carbamazepine; Carbamazepine - therapeutic use; Carotid Artery, Internal - abnormalities; Carotid Artery, Internal - diagnostic imaging; Carotid Artery, Internal - pathology; Carotid Stenosis - diagnosis; Carotid Stenosis - diagnostic imaging; Diagnostic Errors; Dysarthria; Dysarthria - etiology; Female; Hemifacial spasm; Humans; Hypesthesia - etiology; Hypoglossal artery; Hypoglossal Nerve Diseases - etiology; Hypoglossal nerve palsy; Magnetic Resonance Imaging; Medical sciences; Nerve Compression Syndromes - etiology; Neurology; Neurovascular compression; Recurrence; Tomography, X-Ray Computed; Trigeminal neuralgia; Vascular diseases and vascular malformations of the nervous system; Vertebrobasilar Insufficiency - diagnostic imaging; Vertebrobasilar Insufficiency - etiology; Hemifacial spasm; Trigeminal neuralgia; Hypoglossal artery; Hypoglossal nerve palsy; Neurovascular compression; Dysarthria; Carbamazepine; Nervous system diseases; Stomatology; Cardiovascular disease; Language disorder; Trigeminal Neuralgia; Arterial disease; Vascular disease; Communication disorder; Hypoglossal nerve; Intermittent; Artery compression; Neurological disorder
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2012.08.018

Abstract Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy.