A 63-year-old man had a 5-week history of a constant right-sided pulsating headache that was initially temporo-parietal but migrated to the suboccipital area. This was associated with new-onset of dysarthria. On examination, there was deviation of the tongue to the right, and the right-side had a wasted surface appearance, despite what he described as ‘wave-like’ prominence when looking at his tongue in the mirror (figure 1A). The remaining examination was normal. Figure 1 Clear right-sided tongue deviation on protrusion with right-sided wasting (A). Electromyography showing myokymia, comprising highly polyphasic units suggesting mild-to-moderate partial denervation of the right side of the tongue (B). Routine laboratory tests and erythrocyte sedimentation rate were normal. MR scan of brain and internal auditory meatuses showed a cystic lesion in the right hypoglossal canal, appearing to abut the right 12th cranial nerve and to …

中文翻译：

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寰枢关节滑膜囊肿导致舌下麻痹

一名 63 岁的男性有 5 周的持续性右侧搏动性头痛病史，最初为颞顶叶，但转移至枕下区域。这与新发构音障碍有关。经检查，舌头向右偏，右侧表面外观萎缩，尽管他在镜子中看到他的舌头时描述为“波浪状”突出（图 1A）。其余检查正常。图 1 右侧消瘦突出时明显的右侧舌偏（A）。肌电图显示肌运动，包括高度多相的单位，表明舌头右侧有轻度至中度的部分去神经支配 (B)。常规实验室检查和红细胞沉降率正常。