Clinical features
The clinical features of a hypoglossal nerve palsy include:
- loss of power of movement of the tongue
- when examined at rest there may be tongue wasting and fasciculation. These signs indicate lower motor neurone lesion.
- if the patient pokes his tongue out towards the examiner, then the tongue will deviate towards the weaker - affected - side in a unilateral lesion.
- an upper motor neurone lesion of the hypoglossal nerve is usually bilateral and presents with a small, immobile tongue. The combination of a bilateral upper motor neurone lesion of the ninth, tenth and twelfth cranial nerves is called pseudobulbar palsy.
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