Clinical examination
The clinical examination of the hypoglossal nerve involves inspecting the tongue:
- look for wasting and fasciculations indicative of a lower motor neurone lesion
Ask the patient to poke out his tongue:
- if there is a unilateral upper or lower motor neurone lesion then the tongue will deviate towards the side of the lesion - the weaker side
Note, also:
- if there is an upper motor neurone lesion then this is usually bilateral - it will result in a small, immobile tongue
- bilateral lower motor neurone lesion will result in:
- a weak and wasted tongue
- fasciculations
- dysarthria
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