Electromyography findings in radiation-induced unilateral tongue immobility

Head Neck. 2024 Jun;46(6):1304-1309. doi: 10.1002/hed.27692. Epub 2024 Feb 14.

Abstract

Background: We used electromyography to characterize hypoglossal nerve function among radiation-treated head and neck cancer survivors with later onset unilateral tongue immobility.

Methods: Patients with unilateral tongue immobility without evidence of recurrent cancer were seen at a tertiary academic institution between February and September 2021. All patients were at least 2 years post-treatment with radiation therapy for head and neck squamous cell carcinoma. Participants were under annual surveillance and displayed no evidence of operative injury to the hypoglossal nerve.

Results: The median symptom-free interval for the 10 patients included in this study was 13.2 years (range 2-25 years). Myokymia alone was present in 3 of 10 patients, fibrillation potentials alone were present in 3 of 10 patients, and 1 subject displayed both fibrillation and myokymia. Three out of 10 patients had normal hypoglossal nerve function.

Discussion: These findings highlight how disparate mechanisms may underlie similar clinical presentations of radiation-induced neuromuscular dysfunction.

Keywords: electromyography; head and neck cancer; hypoglossal nerve injury; radiation; radiation‐induced cranial neuropathy; tongue immobility.

MeSH terms

  • Adult
  • Aged
  • Electromyography*
  • Female
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Hypoglossal Nerve / radiation effects
  • Male
  • Middle Aged
  • Radiation Injuries* / physiopathology
  • Squamous Cell Carcinoma of Head and Neck / radiotherapy
  • Tongue / innervation
  • Tongue / physiopathology
  • Tongue / radiation effects
  • Tongue Diseases / etiology
  • Tongue Diseases / physiopathology