We describe an unusual and rare case of isolated left hypoglossal nerve palsy secondary to compression from a prominent degenerative osteophyte from the left atlanto-occipital joint. The hypoglossal nerve is a purely motor cranial nerve innervating the tongue musculature. Palsy of the hypoglossal nerve is frequently associated with other cranial nerve palsies and can be related to vascular, neoplastic, infectious or traumatic conditions. Isolated hypoglossal nerve palsy is quite rare and very few cases have been reported in the literature to date.
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