Viral Infection-related Isolated Hypoglossal Nerve Palsy in a 2 Year-old Girl
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Isolated hypoglossal nerve palsy (HNP) is rare in children. Predominantly malignant tumors are the most common cause of HNP, with trauma coming second. A 2-yearold girl with acute onset dysarthria was referred to the pediatric neurology clinic. She also had fever and left-sided tongue deviation upon protrusion. She had no abnormal sign on physical, neurological, and otorhinolaryngological examination other than left hypoglossal nerve palsy. She had no tongue fasciculation. Her brain magnetic resonance imaging and magnetic resonance angiography were normal. In a polymerase chain reaction test, enterovirus was positive in the stool and adenovirus was positive in nasopharyngeal aspirate. We diagnosed viral infection- related isolated HNP and prescribed prednisolone and acyclovir. Within a month, the tongue deviation and dysarthria gradually improved. The first step for the evaluation of isolated HNP should be investigation of the underlying malignancy. However, serologic tests for viral infection are also needed.
Abstract
Isolated hypoglossal nerve palsy (HNP) is rare in children. Predominantly malignant tumors are the most common cause of HNP, with trauma coming second. A 2-yearold girl with acute onset dysarthria was referred to the pediatric neurology clinic. She also had fever and left-sided tongue deviation upon protrusion. She had no abnormal sign on physical, neurological, and otorhinolaryngological examination other than left hypoglossal nerve palsy. She had no tongue fasciculation. Her brain magnetic resonance imaging and magnetic resonance angiography were normal. In a polymerase chain reaction test, enterovirus was positive in the stool and adenovirus was positive in nasopharyngeal aspirate. We diagnosed viral infection- related isolated HNP and prescribed prednisolone and acyclovir. Within a month, the tongue deviation and dysarthria gradually improved. The first step for the evaluation of isolated HNP should be investigation of the underlying malignancy. However, serologic tests for viral infection are also needed.
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