HYPOGLOSSAL NERVE (XII)
Ask patient to open mouth; inspect tongue. Look for - evidence of atrophy (increased folds, wasting) - fibrillation (small wriggling movements).
Ask patient to protrude tongue. Note any difficulty or deviation. (N.B. apparent deviation may occur with facial weakness - if present, assess tongue in relation to teeth.) Protruded tongue deviates towards side of weakness. Non protruded tongue cannot move to the opposite side. Dysarthria and dysphagia are minimal.
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