A 51-year-old Japanese woman was admitted to our hospital because of speech difficulty following severe headache. Neurological examination showed dysarthria and tongue weakness on the right side, indicating right hypoglossal nerve palsy. Needle electromyography of the right side of the tongue showed fibrillation potentials. Magnetic resonance angiography and computed tomography angiography revealed a right, persistent, primitive hypoglossal artery (PPHA) that met Lie's diagnostic criteria. Digital subtraction angiography showed an extended PPHA with irregular caliber in the portion running through the right hypoglossal canal. We diagnosed compression neuropathy of the hypoglossal nerve due to PPHA enlargement based on the findings of ipsilateral hypoglossal nerve palsy, fibrillation that indicated peripheral nerve palsy, and the enlarged diameter of the portion of the PPHA running through the right hypoglossal canal. We prescribed antihypertensive therapy. At 1 year after onset, her tongue weakness was alleviated. Clinicians should consider compression neuropathy due to a PPHA as one of the possibilities in the differential diagnosis of hypoglossal nerve palsy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104459 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A comparative developmental study of the avian syrinx: Insights into the homology of the sound-producing muscles in birds.
J Anat
January 2025
Graduate School of Medicine, Juntendo University, Tokyo, Japan.
The anatomical innovation of sound-producing organs, which gives rise to a wide variety of sound signals, is one of the most fundamental factors leading to the explosive speciation of modern birds. Despite being a key clue to resolving the homology of sound-controlling muscles among birds, only few studies have explored the embryonic development of syringeal muscles. Using serial histological sections and immunohistochemistry, we described the three-dimensional anatomy and development of the cartilage, muscle, and innervation pattern of the tracheobronchi in three avian species: domestic fowls, cockatiels, and zebra finches.
View Article and Find Full Text PDFPolysomnographic features of hypoglossal nerve stimulation efficacy: Looking deeper than the apnea-hypopnea index.
Laryngoscope Investig Otolaryngol
February 2025
Objectives: Hypoglossal nerve stimulation (HGNS) is a promising surgical option for patients with obstructive sleep apnea (OSA) who are intolerant of continuous positive airway pressure therapy (CPAP). Efficacy studies for HGNS stimulation largely focus on the apnea-hypopnea index and/or oxygen desaturation index. This study's objective was to show the physiological effects of HGNS stimulation on upper airway patency, airflow, and treatment effect during polysomnography (PSG) testing.
View Article and Find Full Text PDFUse of Gemini Bipolar Nerve Stimulator as an Alternative to Neural Integrity Monitor in Hypoglossal Nerve Interrogation During Inspire Placement.
J Oral Maxillofac Surg
December 2024
Chief Resident, University of Minnesota, Minneapolis, MN; Associate Surgeon, Oral and Maxillofacial Surgical Consultants, Minneapolis, MN. Electronic address:
Multicentre study conducted across centres in the USA, Europe and Australia to assess the safety and effectiveness of a bilateral hypoglossal nerve stimulation system for the treatment of obstructive sleep apnoea in adults: a protocol for a pivotal, multicentre, open-label, single-arm study.
BMJ Open
December 2024
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Introduction: Obstructive sleep apnoea (OSA) is characterised by blood oxygen desaturations and sleep disruptions manifesting undesirable consequences. Existing treatments including oral appliances, positive airway pressure (PAP) therapy and surgically altering the anatomy of the pharynx have drawbacks including poor long-term adherence or often involving irreversible, invasive procedures. Bilateral hypoglossal nerve stimulation (HNS) is a new treatment for managing OSA, and this study is intended to determine whether an HNS system is a safe and effective treatment option for adults with OSA.
View Article and Find Full Text PDFPropofol-Induced Fasciculations in a Patient With Obstructive Sleep Apnea: A Case Report.
Cureus
December 2024
Anesthesiology, University of Texas Medical Branch, Galveston, USA.
We report a case of a 39-year-old male patient who developed propofol-induced fasciculations during the induction of general anesthesia. The patient had a history of moderate obstructive sleep apnea and was intolerant to continuous positive airway pressure therapy. He subsequently underwent the insertion of a hypoglossal nerve stimulator as a viable surgical intervention.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!