설하 신경병증을 유발한 두개강 외 신경초종
Extra-cranial Schwannoma Causing Hypoglossal Neuropathy
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Various cranial neuropathies caused by intracranial neuroma are well known. However, cranial neuropathies caused by extra-cranial neuroma are scarce compared with intracranial ones. Among them, hypoglossal neuropathy is so rare that only 36 cases of extra-cranial origin were reported. We present the case of 55-year-old female patient presenting two years-lasting choking, aggravated by liquid in-taking during swallowing. Further history taking revealed seven years history of the rugged and rough tongue. Videofluoroscopic swallowing study showed decreased bolus formation and amount of residual materials in vallecular pouch resulting in the secondary overflow aspiration. Electromyography showed a few fibrillation and complex repetitive discharge at the left tongue muscle. As a confirmative study, magnetic resonance imaging revealed schwannoma displacing the left internal carotid artery and internal jugular vein. Her symptoms were well responded to tumor resection & comprehensive dysphagia rehabilitation. his is the first case report of a hypoglossal neuropathy caused by extracranial schwannoma in Republic of Korea.
Abstract
Various cranial neuropathies caused by intracranial neuroma are well known. However, cranial neuropathies caused by extra-cranial neuroma are scarce compared with intracranial ones. Among them, hypoglossal neuropathy is so rare that only 36 cases of extra-cranial origin were reported. We present the case of 55-year-old female patient presenting two years-lasting choking, aggravated by liquid in-taking during swallowing. Further history taking revealed seven years history of the rugged and rough tongue. Videofluoroscopic swallowing study showed decreased bolus formation and amount of residual materials in vallecular pouch resulting in the secondary overflow aspiration. Electromyography showed a few fibrillation and complex repetitive discharge at the left tongue muscle. As a confirmative study, magnetic resonance imaging revealed schwannoma displacing the left internal carotid artery and internal jugular vein. Her symptoms were well responded to tumor resection & comprehensive dysphagia rehabilitation. his is the first case report of a hypoglossal neuropathy caused by extracranial schwannoma in Republic of Korea.
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