Pattern of Tongue Weakness and Subjective Speech and Swallowing Deficits in Unilateral Hypoglossal Nerve Palsy: Case Series of 8 Patients (P4.168)
Bibliographic record
Abstract
OBJECTIVE: To provide a detailed characterization of the nature and utility of symptom and examination characteristics in unilateral hypoglossal nerve palsy. BACKGROUND: Unilateral hypoglossal nerve palsy is a neurologic deficit that frequently portends serious disease, including dissection and neoplasm, and is an important complication of head and neck surgeries, including carotid endarterectomy. Nevertheless, literature and textbook descriptions of patients’ subjective symptoms and the reliability of specific physical examination findings bears conflicting details and is limited in depth, especially regarding incomplete hypoglossal neuropathies. DESIGN/METHODS: We enrolled consecutive patients referred following a request in our tertiary care centre’s Departments of Neurology and Otolaryngology for patients with a persistent unilateral hypoglossal neuropathy. Patients reported their subjective symptoms with focus on any abnormalities of speech or swallowing and were examined and photographed for a series of tongue movements, which were scored for abnormalities by consensus by the two authors. RESULTS: 8 cases were analyzed (4 complete neuropathy, 3 incomplete, 1 unknown). Although 7 patients identified some subtle change in speech, only 2 reported significant impairment. Similarly, although 7 patients identified some subtle swallowing deficit - typically bolus manipulation during the oral phase - only 3 reported impairment, with full adjustment occurring within months. In all patients, the two examination elements that reliably revealed the presence and laterality of the lesion were the resting appearance of the tongue in the mouth and upon protrusion straight forward. Other findings were either inconsistent or had exceptional patient cases lacking impairment. CONCLUSIONS: Unilateral hypoglossal nerve palsy, unlike bilateral weakness, typically presents with subtle patient complaints, even when complete. The tongue at rest and on straight protrusion reliably identify and lateralize the lesion, whereas other movements are variably impaired. Study Supported by: Not applicable.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".