Tongue Wasting
Look For
- Decreased mass of the tongue, unilaterally or bilaterally.
Causes of Tongue Wasting
- Motor neuron disease
- Hypoglossal (XII) nerve lesion - tumour, trauma, infarct, haemorrhage, demyelination, bulbar palsy
Interpretation
- Unilateral wasting - suggestive of a lower motor neuron, involving the hypoglossal nerve (XII) or medullary hypoglossal nucleus
- Bilateral wasting - suggestive of motor neuron disease, Guillain Barre or neurosyphilis
Tongue Fasciculations
Look For
- Spontaneous localised muscle contraction and relaxation. May be associated with dysarthria or dysphagia.
Causes of Tongue Fasciculations
- Motor neuron disease
- Hypoglossal (XII) nerve lesion - tumour, trauma, infarct, haemorrhage, demyelination, bulbar palsy
Interpretation
- Unilateral fasciculations - suggestive of a lower motor neuron lesion, involving the hypoglossal nerve (XII) or medullary hypoglossal nucleus
- Bilateral fasciculations - suggestive of motor neuron disease
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