P14.05 Bilateral hypoglossal palsy after radiation therapy for nasopharyngeal carcinoma: a case report

A 63-year-old lady was adimtted to the EU of Lecco hospital with a clinical history of neck pain in the last 2 months and difficulty in swallowing and chewing and in speech in the last few days.Neurological examination disclosed bilateral deficit in tongue protrusion, more on the left side, with slight amyotrophy of the left side of the tongue.Her remote history included tonsillectomy and - 6 years before - biopsy of a neck lymphnode on the left (histological diagnosis of undifferentiated carcinoma) in the context of a left rhinopharyngeal mass subsequently operated and diagnosed as a lymphoepithelial rinopharyngeal carcinoma, followed by post-surgical radiation therapy.The patient underwent neck and brain MRI with and without gadolinium, which excluded both locoregional tumor relapse and cerebrospinal fluid examination, which ruled out meningeal carcinomatosis; the CSF disclosed normal glucose and total protein values, with 7 mononuclear cells/mm3. Search for viral genome by PCR excluded active infections with HSV, VZV, EBV and CMV. Total body FDG-PET was negative. electromyograpgy showed severe denervation of the tongue muscles suggesting bilateral lesion of the hypoglossal nerve. The remaining cranial-cervical muscles were spared (VII, X and XI). No conduction blocks or dysfunction of the neuromuscular junction were detected.Echocolodoppler study of both carotid and vertebral arteries was normal.The marked difficulties in swallowing compelled the treating ph...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: P14 Neurotoxicity and neuroprotection Source Type: research