A patient with an odontoid fracture and atrophy of the tongue - A case report and systematic review of the literature

Background: Traumatic hypoglossal nerve palsy is a rare entity and has rarely been described in association with an odontoid fracture. Case Description: We present a patient with a posttraumatic odontoid fracture who developed selective weakness of his arms and a unilateral hypoglossal nerve palsy. A systematic review of the literature is presented, and hypothetical causes for the injury are discussed. Conclusion: Bell's cruciate paralysis and central cord syndrome are probably expressions of the same mechanism rather than 2 separate entities based on a preferential damage of pyramidal crossing arm fibers. C2 fractures with concomitant lower cranial nerve injury are relatively rare and have a reasonably good outcome, especially when unilateral. (c) 2005 Elsevier Inc. All rights reserved.