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A 79-year-old woman presented with hoarseness that lasted for 1 year and tongue movement disorder, dysarthria, and dysphagia, which lasted for half a year. Neurologic examination revealed left lingual atrophy and deviation of the tongue to the left (Figure 1A), which was consistent with left hypoglossal nerve palsy.1 A laryngoscope revealed paralysis of the left vocal cord (Figure 1B), which was due to the palsy of the vagus nerve. A cerebral MRI revealed that a giant mass in the parapharyngeal space compressed the left hypoglossal nerve (Figure 2A). Computed tomography angiography revealed a large aneurysm of the left cervical segment of the internal carotid artery (Figure 2B).
Footnotes
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Submitted and editor reviewed. The handling editor was Editor-in-Chief José G. Merino, MD, MPhil, FAHA, FAAN.
- Received October 30, 2022.
- Accepted in final form January 19, 2023.
- © 2023 American Academy of Neurology
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