Unilateral hypoglossal nerve palsy following intubation
DOI:
https://doi.org/10.17161/rrnmf.v7i2_2026.25257Keywords:
neurology, neuromuscular, case report, hypoglossal nerve palsyAbstract
Introduction:
The purpose of this case is to describe a patient who underwent general anesthesia and endotracheal intubation for an exploratory laparotomy who subsequently experienced unilateral hypoglossal nerve palsy.
Case Presentation:
A single patient case is described, from initial presentation for exploratory laparotomy through diagnostic workup and management of unilateral hypoglossal nerve palsy. A 22-year-old woman underwent general anesthesia for an exploratory laparotomy. Intubation was successful with a McGrath size 3 laryngoscope blade and a 7.5 mm endotracheal tube. The day after surgery, the patient noticed significant tongue swelling with a prominent right-sided deviation. Neurology was consulted for evaluation and recommended brain MRI, which demonstrated denervation edema of the posterior right tongue, consistent with neuropraxia and injury to the distal fibers of hypoglossal nerve from the laryngoscope blade used during intubation.
Conclusions:
Unilateral hypoglossal nerve palsy is a rare complication of intubation under general anesthesia. It can be associated with dysphagia and dysarthria, which may be frustrating for patients. Clinicians should be aware of this potential albeit rare complication and its appearance on imaging should they be consulted for evaluation and diagnosis.
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Copyright (c) 2026 Dr. Jaclyn Schneider, Dr. Britta Bureau, Dr. Varun Sampat, Dr. Raquel Farias-Moeller
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
