An Undulating Tongue: Post-Irradiation Myokymia and Neuromyotonia of the Tongue Following Radiation Therapy for Tonsillar Cancer

Delayed complications of radiation therapy affecting the cranial nerves are quite rare. We report a case of tongue myokymia and neuromyotonia following radiation therapy for tonsillar cancer.

Case report: 62-year-old male presented with progressive dysarthria, dysphagia and tongue paralysis and myokymia 10 years after irradiation for tonsillar cancer. Electro diagnostic studies showed myokymic and neuromyotonic discharges, while brain and neck MRI were unremarkable, ruling out tumor recurrence.

Conclusion: Delayed neuropathy of CN XII with tongue myokymia is a rarely reported complication of radiation therapy. Clinicians should be aware of this condition to prevent misdiagnosis.

Author(s): Fabian Rossi, Welwin Liu, Nina Tsakadze, Michael Hoffmann, Ramon Rodriguez-Cruz, Elisa Rossi, Elizabeth Gonzalez, Stephen Castaneda, Aunali Khaku, Maria Franco and Alvaro Estevez

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