Clinical Neurology made easy: A book on history taking and neurological examination (Neurology Series 1) by Bertha C Ekeh

Author:Bertha C Ekeh [Ekeh, Bertha C]
Language: eng
Format: epub
Published: 2019-04-04T17:00:00+00:00

4.11 Hypoglossal (Twelfth) Nerve

In examining the hypoglossal nerve, ask the patient to open his mouth and inspect the tongue. Tremors of the tongue are noted in Parkinson disease whether the tongue is protruded or at rest. Is there evidence of atrophy? This is noted by increased folds and wasting of the tongue. Are there fasciculations? Wasting and fasciculations are features of lower motor neurone lesions. Bilateral fasciculation is almost pathognomonic for motor neurone disease.

Thereafter, ask the patient to put out the tongue as far as possible.

In unilateral hypoglossal lesion, the tongue is been pushed to the weak side instead of been protruded straight. Note that a deviation of the mouth caused by facial nerve paralysis may occur. To differentiate, ask patient to move tongue from side to side to lick the cheek. Note whether this can be done freely.

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