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PubMed2004

Effects of anesthetics on hypoglossal nerve discharge and c-Fos expression in brainstem hypoglossal premotor neurons.

This study examined the effects of anesthesia on the hypoglossal nerve and diaphragm activities and on c-Fos expression in brainstem hypoglossal premotor neurons (pmXII). Experiments were performed in 71 rats by using halothane inhalation, pentobarbital sodium, or mixtures of alpha-chloralose and urethane or ketamine and xylazine. First, various cardiorespiratory parameters were measured in the rats (n = 31) during both awake and anesthetized conditions. The volatile anesthetic halothane, but not the other anesthetics, was always associated with a strong phasic inspiratory activity in the hypoglossal nerve. Second, a double-immunohistochemical study was performed in awake and anesthetized rats (n = 40) to gauge the level of activity of pmXII neurons. Brainstem pmXII neurons were identified after microiontophoresis of the retrograde tracer Fluoro-Gold in the right hypoglossal motor nucleus. Patterns of c-Fos expression at different brainstem levels were compared in five groups of rats (i.e., awake or anesthetized with halothane, pentobarbital, chloralose-urethane, and ketamine-xylazine). Sections were processed for double detection of c-Fos protein and Fluoro-Gold by using the standard ABC method and a two-color peroxidase technique. Anesthesia with halothane induced the strongest c-Fos expression in a restricted pool of pmXII located in the pons at the level of the Kölliker-Fuse nucleus and the intertrigeminal region. The results demonstrated a major effect of halothane in inducing changes in hypoglossal activity and revealed a differential expression of c-Fos protein in pmXII neurons among groups of anesthetized rats. We suggest that halothane mediates changes in respiratory hypoglossal nerve discharge by altering activity of premotor neurons in the Kölliker-Fuse and intertrigeminal region.

Action Potentials↗
PubMed1990

[A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal nerve palsy].

A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy is reported. A 43-year-old housewife was admitted to our hospital with vertigo and left occipital headache. Neurologically, no cranial nerve deficits were present. CT scan and cerebral angiography showed a mass in the lower left posterior fossa. MRI also revealed a well circumscribed extra-axial mass compressing brain stem and cerebellum to the right. Left suboccipital craniotomy was performed and the tumor was removed subtotally. From the operative findings, the 8th to 11th cranial nerves were not related to the tumor, however, the origin of the tumor was not confirmed. The histology showed Antoni A type neurinoma mixed partially with Antoni B type. After the operation, the tongue deviation appeared to the left, but no other cranial nerve deficit was noticed. Post-operative neuroradiological reexaminations defined slight enlargement of the hypoglossal canal. Then, we concluded that the origin of the tumor must have been the hypoglossal nerve. Most intracranial hypoglossal neurinoma grow in the hypoglossal canal followed by enlargement or erosion of the hypoglossal canal. The author thought that this case suggests that this hypoglossal neurinoma originated from a few rootlets of hypoglossal nerve and grew mainly between the medulla and the hypoglossal canal.

Adult↗
PubMed1988

Hypoglossal nerve conduction in normal subjects.

A nerve conduction method is demonstrated for cranial nerve XII, the hypoglossal nerve. Submandibular surface stimulation is performed while recording over the anterior surface of the tongue. There were 30 normal adult subjects and 60 hypoglossal nerves studied. Evoked response parameters are reported as follows: mean latency 2.2 +/- 0.4 msec, mean amplitude 3.8 +/- 1.6 mV (baseline to peak, best of 5 responses). This nerve conduction method is reliable and should expand the electrophysiological assessment of XII cranial nerve motor function.

Adult↗
PubMed1994

Transient unilateral hypoglossal nerve palsy: a case report.

Transient unilateral hypoglossal nerve palsy is very rare. We report an 81-year-old woman with right hypoglossal nerve palsy who recovered in 4 weeks without specific treatment. Extensive investigations did not disclose a cause for her hypoglossal nerve palsy. We believe that hypoglossal nerve palsy may sometimes be self-limited, just as Bell's palsy is.

Aged↗
PubMed1997

Oral manifestations and differential diagnosis of isolated hypoglossal nerve palsy: report of two cases.

Isolated hypoglossal nerve palsy is rare, but occasionally it appears as the initial or solitary sign of an intracranial or extracranial space-occupying lesion, a head and neck injury, or a vascular abnormality of the internal carotid artery. Therefore it should be considered in differential diagnosis. We report two cases of isolated unilateral hypoglossal nerve palsy. In Case 1 the cause of the palsy appeared to be hypoglossal nerve neurilemmoma within the hypoglossal canal, whereas in Case 2 the cause could not be identified. Neither patient complained of any disability other than slight dysarthria. The tongue deviated toward the healthy side at rest and toward the affected side on protrusion. Hemiatrophy of the tongue with fatty displacement was demonstrated by means of T1-weighted magnetic resonance imaging. Dentists who might at times see patients with isolated hypoglossal nerve palsy should be aware of the significance of its oral manifestation, and they should be able to perform differential diagnosis of patients with the condition who appear for treatment.

Adipose Tissue↗
PubMed1997

[Reinnervation of pectoralis major myoflap by the hypoglossal nerve: an experimental study in rabbits].

In order to investigate the morphological, electrophysiological and histochemical characteristics of the pectoralis major myoflaps with original nerve innervation and with hypoglossal nerve reinnervation, after denervation, the model of myoflap transposition to reconstruct the tongue was adopted on 27 New Zealand white rabbits. After the myoflaps were transferred, original nerve innervation (ON), hypoglossal-genioglossus muscle branch nerve implantation (NI) and hypoglossal-genioglossus muscle neuromuscular pedicle implantation (NMP) were performed. The flaps were examined at the intervals of 4, 8, 12 weeks and 16 weeks after operation. The results showed that the denervated myoflaps were reinnervated in NI and NMP, myoflaps contracted when the hypoglossal nerves were stimulated. The histochemical properties of muscle fibers changed. Some type II fibers in the myoflaps transformed into type I fibers, but the pattern of distribution of the muscle fibers displayed mosaic and was similar to that of genioglossus muscle. In terms of speed and scope of reinnervation, the NMP was superior to the NI.

Animals↗
PubMedDate not supplied

[Assessment of reinnervation of the muscles of facial expression following plastic repair of the facial nerve with the descending branch of the hypoglossal nerve (according to electromyographic findings)].

The data of electromyographic studies of the bioelectrical activity of the facial muscles following plastic repair of the facial nerve with the aid of the descending branch of the hypoglossal nerve permit to interpret the succession and quality of the reinnervation of the muscles. Myoelectrogenesis, as shown by the examinations of 13 patients, develops earlier and with greater completeness in the muscles around the mouth than in the orbicular eye muscle and the frontal muscle, which corresponds to the clinical observations. In the process of reinnervation the activity of the zygomaticus muscle favoured the formation of joint and voluntary movements of the orbicular muscle of the eye and of the frontal muscle.

Electromyography↗
PubMed1981

Topographical representation of the hypoglossal nerve branches and tongue muscles in the hypoglossal nucleus of macaque monkeys.

Representation of the hypoglossal nerve branches and tongue muscles was examined in the hypoglossal nucleus of macaques by the horseradish peroxidase method. The nucleus was divided cytoarchitectonically into the medial and lateral divisions at rostral levels, and into the mediodorsal, medioventral, ventral and laterodorsal divisions at caudal levels. The medial, mediodorsal, medioventral and ventral divisions supplied the medial branch. The lateral and laterodorsal divisions supplied the lateral branch. The geniohyoid motoneurons (MN) composed the ventral division. The genioglossus MN were clustered dorsally in the medial division. The hyoglossus and styloglossus MN were located most laterally in the laterodorsal division.

Animals↗
PubMed2005

[Anatomic characteristics and relationship of lingual artery and hypoglossal nerve with tongue base].

OBJECTIVE: To investigate the anatomic characteristics of lingual artery and hypoglossal nerve and relationship between lingual artery and hypoglossal nerve in tongue base, for the purpose of improving data with clinic and increasing safety in the operation of tongue base. METHOD: Twenty extraoral dissections of the submandibular region were performed on 10 human cadavers. The origin and distribution of lingual artery and hypoglossal nerve were observed: (1) The lingual artery was divided into four segments, length and adjacent organs were observed and measured; (2) The hypoglossal nerve length and adjacent organs were observed and measured; (3) The anatomic relationship of lingual artery and hypoglossal nerve was observed and measured. RESULT: The whole length of lingual artery was (9.73 +/- 0.83)cm. At points of foramen cecum of the tongue, 1 cm prior to foramen cecum, 1 cm behind foramen cecum and at adjacent part of foramen cecum to lateral tongue, hyoid, and distances between lingual artery and lateral of the tongue were separately measured. The distances were (2.34 +/- 0.20) cm, (2.48 +/- 0.14) cm, (2.43 +/- 0.26) cm, (2.53 +/- 0.33) cm, (2.14 +/- 0.16) cm, (1.11 +/- 0.09) cm, respectively. At points of foramen cecum of the tongue, 1 cm prior to foramen cecum, 1 cm behind foramen cecum and at adjacent part of hyoid, lateral tongue, and distance between hypoglossal nerve and midline of the inner mandible were separately measured. The distances were(2.28 +/- 0.14) cm, (2.36 +/- 0.16) cm, (2.34 +/- 0.21 ) cm, (1.25 +/- 0.42) cm, (1.86 +/- 0.32) cm, (2.64 +/- 0.28) cm, respectively. The position of the tongue base, lingual artery and hypoglossal nerve are significantly inferior and lateral, that is, 2 cm inferior and (1.11 +/- 0.09) cm lateral to the foramen cecum; (2.08 +/- 0.33) cm medial to the inner mandible. CONCLUSION: This inferior lateral location-'V' type- allows the potential for aggression tongue base resection without neurovascular bundle compromise. To ensure the operating safety, the depth and angle of radiofrequency of the tongue base for OSAHS should be controlled.

Adult↗
PubMed1995

Dexamethasone enhances level of GAP-43 mRNA after nerve injury and facilitates re-projection of the hypoglossal nerve.

Application of dexamethasone was found to induce an enhanced expression level of mRNA encoding the growth associated protein (GAP-43) after peripheral nerve injury. Following hypoglossal nerve axotomy, a dexamethasone releasing pellet (1.5 mg released in 3 weeks) was placed near the transected nerve. GAP-43 mRNA was detected in the hypoglossal nucleus by non-radioactive in situ hybridization histochemistry using an alkaline phosphatase-labeled oligonucleotide probe. A significant elevation of GAP-43 mRNA level was observed 2 weeks after the transection in dexamethasone treated animals. This induction was not observed in the dorsal motor nucleus of vagus which expresses moderately high levels of GAP-43 mRNA even without nerve injury. Although dexamethasone did not alter the maximum level of GAP-43 mRNA in the hypoglossal nucleus after nerve injury, it prolonged the period in which the mRNA expression remained elevated. This may be due to post-transcriptional effect by the glucocorticoid. Dexamethasone treatment also caused a slight facilitation of reprojection. This may be due to the enhancement of GAP-43 mRNA level by the glucocorticoid.

Animals↗
PubMed2002

Repetitive hypoglossal nerve stimulation in myasthenia gravis.

OBJECTIVES: To assess the diagnostic efficacy of repetitive nerve stimulation (RNS) of the hypoglossal nerve in patients with myasthenia gravis (MG) and bulbar symptoms (dysphagia, dysarthria). METHODS: Twenty patients with MG and 25 normal controls had RNS of the hypoglossal nerve. All patients also had single fibre electromyography (SFEMG) of the orbicularis oculi and RNS with recordings of the nasalis, trapezius and abductor pollicis brevis muscles. RESULTS: All patients had positive SFEMG studies. Nine patients with bulbar symptoms had positive hypoglossal RNS, including 3 with negative RNS recordings in other muscles. Eleven patients with no bulbar symptoms showed negative hypoglossal RNS, including two with positive RNS recordings from other muscles. CONCLUSIONS: Abnormal RNS of the hypoglossal nerve correlates well with bulbar dysfunction and further characterises the extent of neuromuscular transmission defect in MG patients.

Adult↗
PubMed2002

High voltage electrical stimulation of the proximal hypoglossal nerve in normal subjects.

OBJECTIVES: It is often difficult to stimulate the proximal hypoglossal nerve by magnetic occipital stimulation, even in normal subjects. Therefore, we tested an improved method of stimulating the proximal hypoglossal nerve, using high voltage electrical stimulation. METHODS: The proximal hypoglossal nerve was activated by high voltage electrical stimulation using surface electrodes over the occipital skull. The compound muscle action potential (CMAP) was recorded from the lingual muscles using surface electrodes in 10 normal subjects. CMAP and F waves produced by distal hypoglossal nerve stimulation and motor evoked potentials produced by transcranial magnetic stimulation were also recorded. RESULTS: When the anode electrode was placed at the mastoid process and the cathode below the inion, the unilateral proximal hypoglossal nerve was readily stimulated supramaximally in all the subjects. The CMAP latency was the same as that obtained with magnetic occipital stimulation. The central motor conduction time (CMCT) calculated from the proximal CMAP was 4.1+/-0.4 ms in the contralateral corticobulbar tract and 4.4+/-0.4 ms in the ipsilateral. The CMCT calculated from the minimal F wave latency was 3.3+/-0.2 ms. CONCLUSIONS: The high voltage electrical stimulation is a useful method for stimulating the proximal hypoglossal nerve to estimate the CMCT of the corticobulbar tract.

Adult↗
PubMed1987

Morphometry of the degenerative process in the hypoglossal nerves in amyotrophic lateral sclerosis.

The peripheral hypoglossal nerves in 13 cases of amyotrophic lateral sclerosis (ALS) and five control cases were examined using morphometrical methods to demonstrate the degenerative process of motor nerve degeneration. The total number of myelinated fibers and their histograms were analyzed according to the degree of severity of the degeneration. Reduction of the total number of myelinated fibers in ALS hypoglossal nerves were graded in three groups: mild 65%-75%, moderate 50%-65% and severe 30%-50% of the myelinated fibers in controls. Each histogram of the remaining myelinated fibers showed different patterns corresponding to the degree of the degeneration and disclosed that the progressive reduction of large myelinated fibers was the fundamental change. Small myelinated fibers were not reduced, but increased, especially in the group with a moderate grade of degeneration. In plastic section, there were clusters of regenerated myelinated fibers. The transient increase of small myelinated fibers may be a reflexion of myelinated fiber regeneration during the progressive degenerative process of the motor neurons. The correlation between the degree of severity of the hypoglossal nerve degeneration and the atrophy of the tongue muscle and the duration of bulbar symptoms was examined and discussed.

Amyotrophic Lateral Sclerosis↗
PubMed2002

Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports.

Rheumatoid arthritis (RA) involvement of the cervical spine is a well-known but perhaps underappreciated phenomenon. Neurologic complications of this involvement include pain, myelopathy, and cranial nerve (CN) palsies. However, hypoglossal nerve palsy (CN XII) is rarely diagnosed. Mechanical nerve injury, either from vertical odontoid subluxation or pannus formation, is the suspected mechanism. We present 2 cases of hypoglossal nerve palsy attributed to cervical spine involvement of RA and 1 case of postoperative tongue weakness after cervical fusion in a patient with long-standing RA. These cases show a potentially devastating complication of RA that may be underdiagnosed. Therapy involving the cervical spine must be prescribed with caution in this patient population.

Aged↗
PubMed2005

Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve.

An unusual case of an intraneural ganglion cyst of the hypoglossal nerve is presented. Only one case of this rare clinical entity has been reported previously. A 51-year-old woman presented with a 6-month history of left-sided hypoglossal nerve palsy. Magnetic resonance imaging revealed a cystic lesion related to the hypoglossal canal. There was no enhancement of the lesion after administration of Gd. A high-resolution computerized tomography scan of the skull base demonstrated an enlargement of the hypoglossal canal. To access the lesion, a far-lateral endoscope-assisted microsurgical approach was used. An intraneural ganglion lesion invading the hypoglossal nerve was found and resected. A histopathological examination confirmed that the lesion was an intraneural ganglion cyst. The occurrence of an intraneural ganglion cyst at the hypoglossal nerve is very rare. This case exemplifies an atypical location of a synovial cyst with cranial nerve involvement.

Atlanto-Occipital Joint↗
PubMed1978

Properties and latencies of potentials evoked in postganglionic sympathetic nerves by electrical stimulation of aortic, sinus and hypoglossal nerves in cats.

The properties and latencies of potentials evoked in cardiac (CN) and renal (RN) sympathetic nerves by electrical stimulation of the sinus, aortic and hypoglossal nerves were studied in cats. Electrical stimulation of the sinus nerve evoked only excitatory responses in the sympathetic nerves. Electrical stimulation of the aortic nerve fibers evoked excitatory or inhibitory responses in sympathetic nerves. It was possible to evoke 4-5 Hz oscillations in CN and RN after electrical stimulation of the aortic and sinus nerve.-It is suggested that electrical stimulation of the baroafferents is partially responsible for "post-excitatory inhibition" in CN and RN. The central transmission time was the same for the aortic and sinus chemoreceptor reflex and for the somatosympathetic reflex. This period was shorter than the central transmission time of the aortic nerve baroreceptor reflex.

Animals↗
PubMed1995

Masseter muscle activity and the hypoglossal nerve.

The effects of severing the hypoglossal nerve and resultant restriction of tongue movement was evaluated for its effect on masticatory jaw movement. Electromyograms of masseter muscles in the feeding rat were recorded 3 days after the nerve severing operation at 1 week intervals. Even after severing the lateral branches of the hypoglossal nerve bilaterally, active-feeding behaviour continued with mastication slightly impaired. After severing the medical branches bilaterally, feeding behaviour was rarely observed, but where eating did take place mastication was impaired with marked disturbance in the masticatory rhythm.

Animals↗