Central Skull Base Osteomyelitis Causing Bilateral Hypoglossal Nerve Palsy

J Korean Neurol Assoc > Volume 28(4); 2010 > Article

Journal of the Korean Neurological Association 2010;28(4): 311-314.

중심성 두개저 골수염에 의한 양측 설하신경마비

선우준상, 손유리 문혜진 박홍균 홍윤호

서울대학교 보라매병원 신경과

Central Skull Base Osteomyelitis Causing Bilateral Hypoglossal Nerve Palsy

Jun-Sang Sunwoo

Department of Neurology, Seoul National University Boramae Hospital, Seoul, Korea

Abstract

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. Key Words: Hypoglossal nerve palsy, Skull base