The forgotten condyle: Delayed hypoglossal nerve palsy caused by fracture of the occipital condyle

Abstract

Fracture of the occipital condyle is a rare injury that can be easily overlooked. Palsies of lower cranial nerves can be the only symptom of the fracture. We report a patient with isolated post-traumatic hypoglossal nerve palsy who developed hypoglossal nerve palsy within 2 months after a car accident, indicating that the acute trauma itself did not damage the hypoglossal nerve. Most likely the palsy is caused by pressure to the nerve prior to the entry or within the hypoglossal canal. Since, in the present case, the fracture was stable and the patient showed only moderate neurological deficits, the operation was deferred.