Abstract
We report a case of nasopharyngeal carcinoma with hypoglossal nerve paralysis as lower cranial nerve paralysis as an initial symptom. A 52-year-old man was admitted to our hospital’s neurology department with the chief complaint of tongue movement disorder. At first, a central disease such as cerebral infarction was suspected due to the sudden onset of lingual movement disorder. A brain MRI was performed, but no intracranial abnormality was detected. Next, the patient was referred to our department for right hypoglossal nerve palsy. Nasopharyngeal endoscopy was performed and a protruding lesion on the right lateral wall to the posterior superior wall of the nasopharynx was detected. Squamous cell carcinoma was diagnosed from the protruding lesion by biopsy. In addition, right cervical lymph node metastasis was recognized by CT scan, so chemoradiotherapy was performed. Cases of nasopharyngeal carcinoma with the chief complaint of hypoglossal nerve paralysis are rare, and few cases have been reported in Japan. We consider the pattern of extension of the tumor and lower cranial nerve paralysis of this case.
