Hypoglossal Nerve Palsy due to Occipito-Cervical Kyphosis: A Case Report

Hypoglossal nerve palsy (HNP) is a potential cause of dysphagia. There have been few reports presenting with HNP associated with spinal diseases. Here, we report a case of HNP caused by postoperative upper cervical deformity. A 66-year-old man presented to our hospital with dysphasia and neck pain. One year prior to his first visit, he had been diagnosed with upper cervical tuberculosis and had undergone posterior C1-C2 fixation. These symptoms, however, further worsened nine months after the initial surgery. The physical examination led to the diagnosis of HNP. Radiographic examination revealed that the O-C kyphosis had been exacerbated and that this deformity was likely the primary cause of HNP. To restore the swallowing function, O-C fusion surgery was performed. Postoperatively, the patient showed immediate improvement of dysphasia with gradual recovery of hypoglossal nerve function. Our results indicate that the kyphosis in O-C junction would be a potential cause of HNP.