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Unilateral Tongue Atrophy and Fasciculation

Nicholas A. Blondin, MD; Anita Huttner, MD; Joachim M. Baehring, MD, DSc
Arch Neurol. 2011;68(11):1478. doi:10.1001/archneurol.2011.652.
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An otherwise healthy 42-year-old woman was involved in a minor motor vehicle crash and taken to a local hospital. On examination, she had right-sided tongue atrophy with visible fasciculations (Figure, A; video). On protrusion, the tongue deviated toward the right. There was no facial weakness, facial sensory impairment, or dysarthria, and the palate elevated symmetrically. There was no weakness of the sternocleidomastoid or trapezius muscles.

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Figure. Examination, imaging, and pathologic findings. A, Right-sided tongue atrophy is visible. B, T1-weighted postcontrast magnetic resonance imaging of the brain demonstrates a homogeneously enhancing extra-axial mass (arrow). C, Hematoxylin-eosin staining of the tumor reveals a meningioma, World Health Organization grade I (original magnification ×10).




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