UNILATERAL COMPRESSION NEUROPATHY OF THE HYPOGLOSSAL NERVE DUE TO HEAD SUSPENSION ORTHOSIS IN MITOCHONDRIOPATHY

Abstract

An 85-year-old woman with multisystem mitochondriopathy experienced tension headache, cervical pain, torque head-posture, and vertigo since 1980 for which she was continuously wearing a head-suspension-orthosis­ since 1990. Since 1996 she developed severe left-sided weakness and wasting of the tongue. Needle-EMG of the left genioglossus muscle revealed abnormal spontaneous activity and reduced interference-pattern. No morphological alterations in the anatomical course of the hypo­glossal nerve were found. Severe, unilateral weakness and wasting of the tongue was interpreted due to chronic compression of the hypo­glos­sal nerve by long-standing use of a head-suspension-orthosis for cervi­cal pain from cervical muscle weakness and resulting spinal degeneration.