Assessment of causality and impairment following unilateral hypoglossal nerve paralysis: A case report Unilateral hipoglossal sinir paralizisinde illiyet bağı ve maluliyet değerlendirmesi: Olgu sunumu


Creative Commons License

İgde E. N., İgde Z. Ö., TAŞTEKİN B., AKÇAN R., Odabası A. B.

Ulusal Travma ve Acil Cerrahi Dergisi, vol.32, no.3, pp.402-407, 2026 (SCI-Expanded, Scopus, TRDizin) identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 3
  • Publication Date: 2026
  • Doi Number: 10.14744/tjtes.2025.73307
  • Journal Name: Ulusal Travma ve Acil Cerrahi Dergisi
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.402-407
  • Keywords: anterior cervical surgery, disability assessment, Forensic traumatology, hypoglossal nerve palsy, medico-legal causality
  • Hacettepe University Affiliated: Yes

Abstract

Isolated hypoglossal nerve injury is an infrequent occurrence in clinical and forensic traumatology practice. Its etiology includes trauma, malignancy, vascular events, autoimmune diseases, and complications of surgical procedures. Clinical manifestations resulting from nerve damage may present early or be delayed. We present the case of a 44-year-old woman who sustained a fracture of the third cervical vertebra following a traffic accident. An anterior approach was employed for instrumentation using an anterior plate spanning two cervical segments. The patient developed dysphagia and swallowing difficulties and subsequently underwent evaluation for disability status. Physical examination revealed significant atrophy and asymmetry of the right half of the tongue body, slight rightward deviation of the tongue apex at rest, and fasciculations. Electromyography performed 22 months after the injury demonstrated chronic axonal injury of the right hypoglossal nerve. Causality assessment favored the traffic accident as the initiating event, with postoperative edema and retraction likely contributing to progression. The condition was classified as permanent, and a 25% functional loss was assigned for tongue paralysis according to national disability criteria. This report highlights the diagnostic, prognostic, and legal complexities of delayed hypoglossal nerve palsy following cervical trauma and underscores the importance of a multidisciplinary approach in determin-ing the etiology and prognosis of isolated hypoglossal nerve paralysis, as well as in establishing medical causality.