An Upper Motor Neuron Lesion Section Causing an Isolated Unilateral Lingual Paresis: A Case Report

A Cerebrovascular Accident (CVA) is a primary cause of mortality and morbidity globally, presenting with a diverse range of appearances contingent upon the location of the infarct. Isolated hypoglossal nerve supranuclear palsy is an uncommon clinical manifestation of ischaemic stroke, typically associated with pre-existing vascular risk factors. The neurological finding of isolated unilateral lingual paresis is rarely observed. While Lower Motor Neuron (LMN) lesions involving the hypoglossal nerve (cranial nerve XII) are extensively described, Upper Motor Neuron (UMN) aetiologies are less commonly noted. This case report discusses solitary unilateral lingual paresis resulting from an UMN infarction, emphasising the clinical manifestation, diagnostic difficulties, and underlying pathophysiology. A 62-year-old individual with type 2 diabetes exhibited dysarthria without accompanying neurological deficits. The Magnetic Resonance Imaging (MRI) revealed an acute non-haemorrhagic infarction in the left corona radiata. The patient demonstrated steady improvement while undergoing dual antiplatelet therapy, high-dose statins, and speech therapy. This case highlights a rare UMN cause of isolated hypoglossal nerve palsy