Central Skull Base Osteomyelitis Causing Bilateral Hypoglossal Nerve Palsy

Bilateral hypoglossal nerve palsy is a rare clinical presentation. We report a case of central skull base osteomyelitis (SBO) presenting with complete tongue paralysis in a 53-year-old man who was not diabetic or immunocompromised. Magnetic resonance imaging demonstrated characteristic features including abnormal contrast enhancement in the clivus (T1-weighted images). Blood tests revealed elevated acute-phase reactants and leukocytosis, which prompted prolonged antibiotic treatment. He responded well to the antibiotics, which together with typical clinical and imaging findings led to the diagnosis of bacterial SBO.J Korean Neurol Assoc 28(4):311-314, 2010KeyWords:Hypoglossal nerve palsy, Skull baseReceived May 22, 2010 Revised July 21, 2010Accepted July 21, 2010＊Yoon-Ho Hong, MDDepartment of Neurology, Seoul National University Boramae Hospital, 25 Sindaebang 2 dong, Dongjak-gu, Seoul 156-707, KoreaTel: +82-2-870-2472 Fax: +82-2-831-2826E-mail: nrhong@gmail.com