Delayed Hypoglossal Nerve Palsy After Halo-Vest Immobilization in a Patient With C1-C2 Tuberculosis: A Case Report. Issue 3 (12th July 2022)

• Record Type: Journal Article
• Authors: Basu, Saumyajit; Gohil, Kushal
• Is Part Of: JBJS case connector. Volume 12:Issue 3(2022)
• Publication Date: 2022-07-12
• Subjects: atlas -- axis -- C1-C2 tuberculosis -- Halo vest immobilization -- delayed hypoglossal nerve palsy; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00053
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: A 48-year-old man presented with neck pain and torticollis without any neurodeficit. He was diagnosed with C1-C2 tuberculosis with left C1-C2 joint destruction and was immobilized with a halo vest and started on antitubercular treatment (ATT). At the 3-month follow-up, he presented with left hypoglossal nerve palsy (HNP). He responded to ATT with complete healing of C1-C2 lesion and good correction of deformity but persistent left-sided tongue deviation at the 2-year follow-up. Conclusion: HNP may occur as a complication of conservative management of craniovertebral junction tuberculosis (CVJ TB). Careful neurological assessment and monitoring must be performed while correcting deformities in CVJ TB using halo-vest immobilization.