Delayed hypoglossal nerve palsy following occipital condyle fracture

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Delayed hypoglossal nerve palsy following occipital condyle fracture.

A 44-year-old man, a victim of a road traffic accident, presented to the emergency department 4 days after the incident. He complained of persistent neck pain and headache at the time of presentation. The computed tomography (CT) of the cervical spine showed minimally displaced occipital condyle fracture (OCF) on the right side and normal findings of brain parenchyma. After a week of hospitalization, he had few episodes of vomiting, and he complained of slurring of speech and on the following day he had difficulty in swallowing. There was neither deterioration in GCS nor any abnormal motor/sensory findings. The examination of all cranial nerves, except for the right hypoglossal nerve were normal. There were fasciculations and deviation of the tongue to the right side. All other examinations of the central nervous system showed unremarkable findings. Based on these findings, a diagnosis of delayed hypoglossal nerve palsy secondary to occipital condyle fracture was made.

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