Damage to the lingual nerve can cause great harm to the body. The hypoglossal nerve is one of the 12 pairs of cranial nerves. When nerve damage occurs clinically, there are many symptoms. For example, the patient's tongue muscles will be completely paralyzed, the patient will speak unclearly, and will have difficulty swallowing. Sometimes it will cause enhanced mandibular reflexes, which are quite harmful to the patient and require timely and formal treatment. Symptoms of lingual nerve damage 1. Simple peripheral hypoglossal nerve injury: In unilateral hypoglossal nerve paralysis, the tongue muscles on the affected side are paralyzed, the tongue tip deviates to the affected side when the tongue is extended, and the tongue muscles on the affected side atrophy; in bilateral hypoglossal nerve paralysis, the tongue muscles are completely paralyzed, the tongue is located at the bottom of the mouth and cannot be extended, and there are difficulties in speaking and swallowing. 2. Hypoglossal nerve injury with posterior cranial nerve injury (bulbar palsy) The main classifications and clinical manifestations of medullary paralysis are: (1) Lower motor neuron medullary paralysis, also known as bulbar palsy, is clinically manifested as paralysis and atrophy of the muscles of the pharynx, larynx, palate, and tongue innervated by the medullary nerves. Difficulty in swallowing may be seen, food may choke out of the nostrils when eating, hoarseness, difficulty speaking, unclear articulation, and disappearance of the pharyngeal-palatal reflex. Nuclear lesions may also cause tongue fasciculation. (2) Upper motor neuron bulbar palsy is also called pseudobulbar palsy. Its clinical manifestations include paralysis or incomplete paralysis of the muscles innervated by the medulla oblongata, difficulty in moving the soft palate, pharynx, and tongue muscles, and difficulty in swallowing, pronouncing, and speaking. Because it is an upper motor neuron paralysis, there is no muscle atrophy, the pharyngeal reflex exists, the jaw reflex is enhanced, and strong crying and laughing may occur. Causes1. Central hypoglossal nerve injury (1) Bilateral supranuclear palsy and unilateral supranuclear tongue paralysis can be caused by various causes, but the most common are medullary palsy caused by the sequelae of multiple or multiple strokes, amyotrophic lateral sclerosis, diffuse cerebral vascular sclerosis, multiple sclerosis, multiple cerebral infarction, syphilitic cerebral arteritis, syringobulbar disease, poliomyelitis, cerebrovascular disease, cerebral hemorrhage, cerebral embolism, intracranial tumors and craniocerebral injury. (2) Nuclear lesions of the hypoglossal nerve, vascular lesions of the medulla oblongata, syringomyelia, progressive bulbar palsy; malformations of the skull and neck, such as basilar invagination and congenital cerebellar tonsillar herniation; metastatic cancer infiltration at the base of the skull (such as nasopharyngeal carcinoma); lesions near the foramen magnum, such as tumors, fractures, meningitis, and neck tumors. 2. Peripheral hypoglossal nerve injury is mainly caused by peripheral lesions of the hypoglossal nerve. The most common causes are skull base fractures, aneurysms, tumors, submandibular injuries (gunshot wounds), cervical dislocation, occipital condyle fractures, anterior occipital foramen periostitis, and accidental or intentional injuries during surgery on the skull base or neck (such as anastomosis of the hypoglossal nerve and facial nerve), as well as primary tumors of the hypoglossal nerve. The signs of peripheral hypoglossal nerve damage are basically similar to those of hypoglossal nerve nucleus damage, except that the tongue muscle paralysis is unilateral. |
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