Isolated Tongue Paralysis as Presentation of Seropositive Neuromyelitis Optica Spectrum Disorder

ABSTRACT

Neuromyelitis optica spectrum disorder (NMOSD) is characterized by a characteristic clinical presentation or positivity for the anti-aquaporin-4 antibody. Lesions involving the dorsal medulla are typical of NMOSD, but isolated tongue paralysis has not been reported previously. We report a rare case of NMOSD presenting with isolated tongue paralysis and swelling due to intrinsic tongue muscle paralysis, which was caused by bilateral involvement of the hypoglossal nuclei in the lower dorsal medulla oblongata.