## Overview Damage to the hypoglossal nerve (cranial nerve XII) paralyzes the tongue and associated muscles (including geniohyoideus), producing severe dysphagia. Food and water return from the nostrils, the tongue may hang out or deviate, and aspiration pneumonia is a major risk. Common causes include guttural pouch mycosis and complications of strangles. ## Causes Guttural pouch mycosis, retropharyngeal abscess, trauma, or other lesions affecting cranial nerve XII. ## Diagnosis Clinical signs of tongue paralysis and dysphagia, plus endoscopy of the guttural pouches and pharynx. Neurologic examination confirms hypoglossal involvement. ## Treatment Treatment of the underlying disease (antifungals for guttural pouch mycosis, drainage of abscesses). Supportive feeding (nasogastric or esophagostomy tube) and management of aspiration. Nerve recovery is often incomplete. ## Recovery and Prognosis Guarded. Many horses have permanent deficits. Aspiration pneumonia significantly worsens survival. ## Prevention Prompt treatment of guttural pouch infections and strangles complications.
food and water returning from the nostrils; tongue hanging out or deviated; inability to swallow; weight loss; aspiration pneumonia risk
## Overview Damage to the hypoglossal nerve (cranial nerve XII) paralyzes the tongue and associated muscles (including geniohyoideus), producing severe dysphagia. Food and water return from the nostrils, the tongue may hang out or deviate, and aspiration pneumonia is a major risk. Common causes include guttural pouch mycosis and complications of strangles. ## Causes Guttural pouch mycosis, retropharyngeal abscess, trauma, or other lesions affecting cranial nerve XII. ## Diagnosis Clinical signs of tongue paralysis and dysphagia, plus endoscopy of the guttural pouches and pharynx. Neurologic examination confirms hypoglossal involvement. ## Treatment Treatment of the underlying disease (antifungals for guttural pouch mycosis, drainage of abscesses). Supportive feeding (nasogastric or esophagostomy tube) and management of aspiration. Nerve recovery is often incomplete. ## Recovery and Prognosis Guarded. Many horses have permanent deficits. Aspiration pneumonia significantly worsens survival. ## Prevention Prompt treatment of guttural pouch infections and strangles complications.
food and water returning from the nostrils; tongue hanging out or deviated; inability to swallow; weight loss; aspiration pneumonia risk