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Electrophysiology of Cranial Nerve Testing: Spinal Accessory and Hypoglossal Nerves

Stino, Amro, M.*; Smith, Benn, E.

Journal of Clinical Neurophysiology: January 2018 - Volume 35 - Issue 1 - p 59–64
doi: 10.1097/WNP.0000000000000439
Invited Review

Summary: Multiple techniques have been developed for the electrodiagnostic evaluation of cranial nerves XI and XII. Each of these carries both benefits and limitations, with more techniques and data being available in the literature for spinal accessory than hypoglossal nerve evaluation. Spinal accessory and hypoglossal neuropathy are relatively uncommon cranial mononeuropathies that may be evaluated in the outpatient electrodiagnostic laboratory setting. A review of available literature using PubMed was conducted regarding electrodiagnostic technique in the evaluation of spinal accessory and hypoglossal nerves searching for both routine nerve conduction studies and repetitive nerve conduction studies. The review provided herein provides a resource by which clinical neurophysiologists may develop and implement clinical and research protocols for the evaluation of both of these lower cranial nerves in the outpatient setting.

*Department of Neurology, Division of Neuromuscular Medicine, Ohio State University, Columbus, Ohio, U.S.A.; and

Department of Neurology, Mayo Clinic, Scottsdale, Arizona, U.S.A.

Address correspondence and reprint requests to Amro M. Stino, 395 W, 12th Avenue, 7th Floor, Columbus, OH 43210, U.S.A.; e-mail:

The authors have no funding or conflicts of interest to disclose.

© 2018 by the American Clinical Neurophysiology Society