Question 2298
{"accessible":false,"alternatives":[{"id":11372,"text":"supranuclear affecting the right hypoglossal nerve"},{"id":11373,"text":"infranuclear affecting the right hypoglossal nerve"},{"id":11374,"text":"supranuclear affecting the left hypoglossal nerve"},{"id":11375,"text":"infranuclear affecting the left hypoglossal nerve"}],"archived":false,"correctAlternativeId":11374,"explanation":"\u003cp\u003eThe presentation and demographic is in keeping with a right-sided cortical \u003ca href=\"/articles/stroke\"\u003estroke\u003c/a\u003e. As such, the presenting \u003ca href=\"/articles/hypoglossal-nerve-palsy\"\u003ehypoglossal nerve palsy\u003c/a\u003e is likely to be supranuclear in nature (i.e. above the \u003ca href=\"/articles/medulla-oblongata\"\u003emedulla\u003c/a\u003e)\u0026nbsp;and located\u0026nbsp;on the right side (i.e. right cerebral cortex).\u003c/p\u003e\u003cp\u003eIn most individuals, the \u003ca href=\"/articles/hypoglossal-nucleus\"\u003ehypoglossal nuclei\u003c/a\u003e receive a significant component of contralateral cortical innervation. As a result, a right-sided cortical stroke leads to a supranuclear palsy of the left \u003ca href=\"/articles/hypoglossal-nerve-1\"\u003ehypoglossal nerve\u003c/a\u003e. In this case, the tongue deviates to the left due to the resulting\u0026nbsp;weakness of the left \u003ca href=\"/articles/genioglossus-muscle\"\u003egenioglossus muscle\u003c/a\u003e.\u003c/p\u003e","id":2298,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2330","nextQuestionPath":"/articles/stroke/questions/2256","relatedArticles":[{"id":52431,"title":"Genioglossus muscle","link":"/articles/genioglossus-muscle?lang=us"},{"id":98541,"title":"Hypoglossal nerve palsy","link":"/articles/hypoglossal-nerve-palsy?lang=us"},{"id":1483,"title":"Hypoglossal nerve","link":"/articles/hypoglossal-nerve-1?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 50-year old male with an extensive smoking history presents with sudden-onset left arm and hand weakness, astereognosis\u0026nbsp;and dysarthria.\u003c/p\u003e\u003cp\u003eWhen asked to protrude his tongue, it deviates to the left. This clinical finding most likely represents a hypoglossal nerve palsy that is which of the following?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2298"}],"attemptsPercentages":[{"alternativeId":"11373","percentage":11},{"alternativeId":"11375","percentage":13},{"alternativeId":"11372","percentage":32},{"alternativeId":"11374","percentage":45}],"promptToLogin":false,"questionManager":false,"articleId":"stroke"}