Transient total tongue paralysis from simultaneous central and peripheral lesions

The scan disclosed early stroke changes in the right frontal lobe. Because of the Horner's sign on the right side, a carotid angiogram was performed (at 2 hours into his stroke). The lack of any sign of denervation on needle EMG examination performed 2 weeks after the ICA dissection, along with the rapid functional recovery, suggest that the weakness on the right side of the tongue was probably due to a neurapraxic injury resulting in a conduction block, which recovered quickly.