Paralysis of the tongue

Introduction When the tongue is extended, the tip of the tongue is biased to one side, or left or right, called the tongue. The lingual muscle of the diseased side is paralyzed, unable to contract, and slightly stretched, the tongue is uneven on both sides and hemiplegia, so the tip of the tongue is left to the left when the left tongue is paralyzed, and the tip of the right tongue is paralyzed to the right. This disease is common in stroke, which is a cerebrovascular accident.

Cause

The facial nerve and hypoglossal nerve of the lower muscle of the dominating face are damaged. The lingual nerve is connected to the brain, and the tongue is the forerunner of the brain. The tongue is stiff and skewed, which is a harbinger of problems such as stroke and facial paralysis.

Sublingual nerve palsy: When one side of the hypoglossal nerve is paralyzed, the tongue is biased toward the disease side, the affected side of the tongue muscle is atrophied, and often accompanied by muscle fiber fibrillation; swallowing and pronunciation are generally more difficult. When the bilateral hypoglossal nerves are paralyzed on both sides, complete tongue numbness occurs, and the tongue can not move at the bottom of the mouth, causing difficulty in eating and swallowing, and dysphonia, especially when the tongue is sounded. Separate hypoglossal nerve palsy is also rare, and can occur in deep neck injuries, spinal tuberculosis, medullary cavity, early malignant tumors of the base of the tongue, and rare sublingual neurofibromatosis.

an examination

Related inspection

Oral X-ray examination of oral endoscope

1. X-ray film and tomogram: including tomographic X-ray films of the skull, head and neck, cervical X-ray film and jugular foramen.

2. X-ray angiography

(1) spinal iodine oil angiography; (2) hypoglossal neuroma angiography; (3) carotid artery and / or vertebral artery angiography; (4) cerebellar tonsil mandibular malformation cerebral angiography and spinal cord iodine (oil) angiography an examination.

3. CT and MRI: CT scan of the cranial-cervical junction area, especially MRI, can diagnose the tumor inside and outside the occipital foramen and upper cervical spinal cord, and clearly show the tumor and the medulla, cervical spinal cord and vertebral artery, Adjacent relationship of the inferior cerebellar artery. CT scan of hypoglossal neuroma showed that the cerebellopontine angle occupied and the image was enhanced.

Differential diagnosis

Differential diagnosis of lingual muscle paralysis :

Facial nerve palsy (facial neuritis, Bell's palsy, Hunter syndrome): commonly known as "face ", "", "", "hanging wind", "hanging wind", "facial neuritis", ""Mouth wind", etc., is a common disease characterized by facial dysfunction of facial muscles. The general symptom is the distortion of the mouth and eyes. It is a common and frequently-occurring disease that is not limited by age and gender. The patient's face often fails to complete the basic eyebrow lifting, eye closing, drumsticks, and mouth.

Stroke (apoplexy): It is a disease that suddenly faints, is unconscious, has a skewed mouth, is unfavorable in language, is half-baked, or is not clinically ill. Due to the rapid onset of the disease, the symptoms are very versatile, and the condition changes rapidly. It is similar to the characteristics of the wind and the good behavior, so it is called stroke and stroke. The incidence and mortality of this disease are high, and often have sequelae; in recent years, the incidence rate is increasing, and the age of onset is also becoming younger. Therefore, it is a major disease that threatens human life and quality of life.

The facial nucleus and the hypoglossal nucleus of the lower part of the dominating surface are unilateral (contralateral), and the other cranial nerve nucleus receives the fibers of the bilateral cortical nucleus. The motor neurons on one side are damaged, and the facial muscles and contralateral lingual tendons below the contralateral ocular lobes can be produced. The contralateral nasolabial fold disappears, the sulcus is drooped and skewed toward the lesion side, and it can not be done. Drumsticks, tooth decay, etc., when the tongue is extended, the tip of the tongue is biased to the opposite side of the lesion. When the facial nerve is paralyzed on one side, it can cause all facial muscle spasm on the side of the lesion, which is characterized by the disappearance of the frontal transverse stripes, the inability of the eyes to close, the drooping of the mouth, and the disappearance of the nasolabial fold. One side of the sublingual nerve motoneurons is damaged, which can cause all tongue tendons on the lesion side, which is characterized by the tip of the tongue leaning toward the lesion side when the tongue is extended. In some cases of peripheral facial paralysis, the deviation of the tongue can be seen. At this time, the tongue is always skewed toward the healthy side. This is due to paralysis of the styloid and genioglossus muscles that are innervated by the facial nerve.

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