This work was done by 2nd year student in faculty of medicine,Menoufia University under supervision of staff of anatomy and embryology department

1. Tongue paralysis
ON
Menoufia faculty of medicine

2. Under
supervision
Dr/ Hanaa Noah
Dr/ Engy Abd el azeem
Dr/ Lubna Taher
• Dr/ Amira Ahmady
• Dr/ Amira Fathy
• Dr/ Amira Elmeligy
• Dr/ Alaa Mousa
• Dr/ Alaa Saber
• Dr/ Alshimaa Elsalakawy
• Dr/ Gihan Osama
• Dr/ Ahmed Salama
• Dr/ Ehab Adel
• Dr/ Wael Elkattan
by

3. Outlines
• What is the tongue?
• Development of the tongue
• Anatomy of the tongue
• Tongue paralysis
Definition
Causes
Epidemiology
Diagnosis
-history & examination
- clinical picture
-investigation
• Treatment
• Prevention
• Prognosis

4. What is the tongue?

5. Development of the tongue

6. Anatomy of the tongue

7. Hypoglossal nerve
Supranuclear
Infranuclear
Nuclear

8. Muscle of the tongue
Extrinsic Intrinsic

9. What is tongue paralysis?

10. Definition
• It is inability of the patient to shrink
little elongate tongue on both side
when tongue out , tongue to one side ,
or left or right called tongue paralysis

11. Historical Background
• The first recorded description of the unnamed
hypoglossal nerve was by Herophilos (335–280
BC).
• The first use of the name hypoglossal in Latin as
nervi hypoglossi externa was used by Winslow in
1733.
• This was followed though by several different
namings including nervi indeterminati, par
lingual, par gustatorium, great sub-lingual by
different authors, and gustatory nerve and lingual
nerve (by Winslow).
• It was listed in 1778 as nerve hypoglossum
magnum by Soemmering.
• It was then named as the great hypoglossal nerve

12. Causes
Damage or lesions to the hypoglossal
nerve.
It is classified to:
 Nuclear.
 Supranuclear (UMNL).
 Infranuclear (LMNL).
 It is either unilateral or bilateral

13. Causes

14. Epidemiology

15. • About 30.5% varied geographic location
• Sex : more in males
• Age :
* more freqenty in adulthood
* prominance increase by age
Epidemiology

16. Diagnosis

17. Symptoms
Deviation of the tongue
Fasciculations may apear
Slurring of speech
Difficulty chewing & swallowing

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Examination
• We ask the patient to produce his
tongue

19. Investigations

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The relevant checks
• X-ray and radiographs: including the skull, head
and neck, cervical spine X-ray region of the jugular foramen,
and X-ray tomography.
• X-ray contrast
1. spinal cord lipiodol
2. the hypoglossal nerve tumors angiography
3. the carotid artery and (or) the vertebral artery angiography
4. chiari malformation brain imaging and spinal cord iodine
gas water (oil) angiography checks
• CT and MRI : craniocervical junction tumors
underwent CT scans

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Treatment

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1. Speech therapy should be given
2. Exercise for treatment of dysarthria may help to
improve tongue co.ordination and strength.
3. Corticosteroids may reduce secondary injury by
reducing tissue edema and inflammation .
4. In addition to steriod therapy

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Prevention

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Good prenata care
Seatbelts , air bage ,
helments
Controlling blood
pressure and
cholesrtrol

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Hypoglossal nerve injury care :
Good rest
1 2
Improve
immune function
Adequate supply
of
nutrients
3

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