Unilateral isolated hypoglossal nerve palsy: A rare complication of Diabetes Mellitus

Abstract

We report a middle-aged male who presented with sudden onset slurring of speech with polyuria and polydipsia of three weeks duration. Evaluation suggested unilateral hypoglossal nerve palsy. The patient was detected to have uncontrolled hyperglycemia and exhaustive workup for possible alternative etiology including connective tissue disorders, retropharyngeal infection, hypothyroidism, thrombosis of median branches of vertebral artery, lacunar infarct over the hypoglossal nerve nucleus, multiple sclerosis, epilepsy, malignancy etc. was unrewarding. Unilateral isolated hypoglossal nerve palsy not only unmasked his diabetes, but also got corrected following glycemic control. The case report exemplifies a relatively infrequent clinical manifestation of diabetes, thereby reiterating that although unilateral isolated hypoglossal nerve palsy is rare, nevertheless warrants thorough evaluation before being labelled as “idiopathic” and diabetes remains one amongst various potentially reversible medical causes.