A stroke refers to a sudden cessation of blood flow to the brain, causing the limbs of the body to shut down. The most widely known signs are slurred speech and slow movements, but the symptoms vary depending on which part of the brain is affected. Sometimes the nerve that controls the tongue is damaged, which can lead to a change in the appearance of the tongue.
Many stroke survivors report more common symptoms such as confusion and paralysis.
Although tongue deviation is less common, it is recognized in stroke patients.
“The tongue will tend to deviate from the midline when pulled or protruded and deviate towards the lesion,” Biomedical Engineering Online explains.
In other words, a twisted tongue that is slanted to one side or the other may indicate nerve damage from a stroke.
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Biomedical Engineering Online adds: “This is called tongue deviance, so symptoms of tongue deviance are seen with a stroke or transient ischemic attack.”
For a long time, twisted tongue was considered in traditional Chinese medicine as a warning sign of “wind blow”.
In a mini-stroke, also known as a transient ischemic attack, the damage to the brain is so minor that it can be compensated by the blood supply to other areas, and full recovery occurs.
However, if the hypoglossal nerve is damaged during a mini-stroke, symptoms such as tongue deviation may persist.
In fact, the deviation of the language indicates damage to the motor cortex of the brain.
This means that the hypoglossal nerve, which controls tongue movements, will be damaged.
In 2014, the journal Stroke described the case of a 40-year-old white male with a history of transient idiopathic thrombocytopenia, a known precursor to stroke.
The authors said: “Four days before entering the emergency room, he realized that he could not move his tongue to the left while chewing bread.”
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After the cause of the symptoms could not be found, the patient was referred to a neurologist for further evaluation.
Follow-up MRI showed that the left internal carotid artery was dilated and lengthened, a phenomenon known medically as dolichoectasia.
The researchers speculated that the expansion may have led to hypoglossal nerve compression and the patient’s symptoms.
The patient also reported difficulty in swallowing, which was probably caused by impaired tongue motility.
Paralysis of a single hypoglossal nerve is a relatively rare manifestation of a stroke, in almost half of cases caused by cancer.
When the hypoglossal nerve, also known as the 12th cranial nerve, becomes damaged, it causes weakness or wasting of the tongue.
Merck’s manual explains, “Disorders of the hypoglossal nerve can be caused by tumors, strokes, infections, trauma, or amyotrophic lateral sclerosis.”
Since the hypoglossal nerve allows the tongue to move from side to side, paralysis of this nerve causes difficulty in eating.