Sublingual nerve. Examination of the hyoid nerve

People who do not have medical education can hardly imagine what a sublingual nerve is. But in some cases this information can be very important. There are a number of problems that worsen the quality of life of a person connected with the tongue and the hyoid nerve. Let us consider them in more detail.

Just about the complex

The sublingual nerve innervates, that is, it connects the nerve endings of the tongue with the central nervous system. It provides motor (efferent) innervation, allowing the CNS to control the activity of the tongue and the circular muscle of the mouth. The nerve is paired, it is the twelfth pair of cranial nerves. It emerges from the anterolateral sulcus, and its nucleus is located along the medulla oblongata.

The maxillofacial nerve sends impulses and provides activity of the upper, lower, longitudinal, transverse and vertical muscles of the tongue. He is responsible for the movement of the chin-lingual, sublingual-lingual and subulate muscles.

How to understand the doctor. Meaning of terms

Since the information about the sublingual nerve is a little difficult to understand, patients do not always understand what the expert is talking about. To understand the diagnosis, you need to know some terms:

1. Gemiglossoplegia. This term denotes paralysis of half of the tongue.
2. Glossoplegia is a state of complete paralysis of the tongue.
3. "Dysarthria". Diagnosis, indicating a violation of articular speech. Indistinctness is accompanied by a sensation of extraneous substance in the mouth.
4. "Anarthria" is a diagnosis that specifies that articulate speech is impossible.

These terms are found in the case histories associated with the sublingual nerve, quite often. Their value is better remembered.

What does the patient complain about?

When referring to a doctor, patients mostly complain about the weakness of the tongue. It is difficult for them to speak, and sometimes even to swallow. Gradually the problem grows, and the language moves ever worse. The patient may feel that he has a "mouth full of porridge", because of which his speech is difficult to make out. In complex cases, speech is completely lost.

Medical examination

If an expert suspects that the sublingual nerve is affected, the symptoms will be determined when examining the tongue in the oral cavity. First of all, the doctor asks to stick out his tongue. Do not be surprised, this simple action can point to the main problem. The doctor will be able to visually determine the degree of the disease. If the sublingual nerve does not function well, then the tongue deviates to the side. This is due to muscle hypotension on the one hand. The whole surface of the organ looks wrinkled and becomes uneven. But here it is necessary to take into account that many patients deliberately reject the tongue towards the doctor, so that he can better examine it. If there is any doubt whether the tongue is arbitrarily or involuntarily rejected, the patient is offered to touch the upper lip with the tip. If there is no pathology, then the tip will be located in the middle, if the nerve is struck - will shift to the side.

In addition to rejection, the physician should pay attention to atrophy and fibrillar twitching.

Two-sided lesion of the sublingual nerve is observed in about 20% of cases. This disease can be treated worse and can lead to a complete loss of speech.

Variants of diagnosis. Neuropathy

In fact, neuropathy is a nerve damage that is non-inflammatory. In the case of the sublingual nerve, this diagnosis is divided into central and peripheral neuropathy.

Central affects the cortical pathways of the nerve. The problem affects the cortex and the nucleus of the twelfth pair of cranial nerves. This type of neuropathy is usually combined with the problems of the facial nerve. The tongue when protruding deviates into the opposite side of the lesion side, since the nucleus of the hyoid nerve has connections with the opposite hemisphere. Atrophy and fibrillar twitching are not observed.

The process can have several stages. If the sublingual nerve is affected only in the area of the internal department, then only the functions of the lingual muscles are affected.

If the lesion starts below the exit from the hypoglossal nerve channel, the problem affects the nerve fibers connected to the cervical roots. This leads to a disruption in the functioning of the muscles that hold the larynx. When swallowed, there will be a shift in the healthy side.

Peripheral Neuropathy

Peripheral paralysis of the hyoid nerve is diagnosed if the process involves an intracerebral spine or nucleus. Doctors can use the phrase "paresis of the muscles of the tongue." Both of these names are equivalent. Most often this disease has a one-sided nature, but if the pathology of the nuclei is observed, muscle damage can occur on both sides. On examination, the atrophy of the problematic part of the tongue is noticeable. The fabric loses its elasticity, becomes flabby and "crumpled." If the case is severe, then the motor activity of the organ is significantly limited.

If the hyoid nerve is affected on one side, then in the oral cavity the tongue shifts to the healthy side. When a patient puts out his tongue, he moves to the sore side. The doctor can observe fibrillar tremor (twitching). Sometimes this process is confused with the usual twitching of the muscles, which can happen with the tension of the tongue during protrusion. If the specialist has noticed a similar phenomenon, he should ask the patient to relax the muscles of the tongue. Normal muscle tremor will pass, and fibrillar will remain.

With a deep nuclear lesion of the nerve, an additional symptom may be atrophy of the circular muscle of the mouth. The patient is not able to perform the simplest actions - to put his lips in a tight tube, whistle, blow.

With bilateral flaccid paresis, the paralyzed organ lies on the bottom of the oral cavity. Speech and the ability to swallow are significantly impaired.

The causes of the defeat of the nucleus of the hyoid nerve are serious enough. Among the most common are:

• Bulbar palsy;
• Motor neuron disease, that is, defeat of motor neurons ;
• Syringobulbia;
• polio;
• Cardiovascular problems.

More details explain the manifestations of several diseases.

Bulbar and pseudobulbar syndrome

The cause of the first disease is a degenerative degeneration of tissues in the cerebral cortex, a violation of blood supply to the medulla oblongata, the appearance of stem tumors, polyencephalomyelitis, pathology of the structure, trauma to the base of the skull.

Symptoms: immobility of epiglottis, larynx and soft palate, change of voice, loss of intelligible speech, difficulty with swallowing (liquid food can flow into the nose), respiratory failure. Vocal cords in the "cadaverous position", the tongue fibrillar twitch. If the facial and the trigeminal nerve are additionally affected, the chewing muscles atrophy, and the lower jaw hangs.

Pseudobulbar syndrome is very similar to bulbar syndrome , but this is a defeat of the cortical connections from both sides. Affected more of the cranial nerves, including the sublingual nerve, is the brain ischemia. Symptoms are added salivation, reflex movements of eyeballs, attacks of crying or laughter, dementia and decreased intelligence.

Methods of diagnosis and treatment

The doctor conducts an anamnesis, performs a visual examination, to confirm the diagnosis, appoints CT or MRI of the brain. This allows you to find out the cause of compression of the sublingual nerve.

Any treatment is appointed after confirmation of the diagnosis. The main goal is a positive effect on the underlying disease. Self-medication is unacceptable!