Abnormal Movements of the Tongue, Uvula, and Pharynx

CLINICAL DIAGNOSTIC MANUAL

Abnormal movements of the tongue, uvula, and pharynx can indicate neuromuscular or neurological dysfunction affecting the coordination and motor control of these structures.

These movements can present as tremors, spasms, weakness, or paralysis, significantly impacting critical functions such as swallowing, speech, and breathing.

The underlying causes are varied and may involve damage to specific cranial nerves as well as dysfunctions in upper and lower motor neurons. A thorough clinical evaluation and the use of complementary tests are essential to identify the precise etiology and plan appropriate management.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Glossopharyngeal nerve lesion	Difficulty swallowing, loss of gag reflex, altered sensation in the posterior tongue and pharynx, pharyngeal pain	Clinical history, neurological exam	EMG, nerve conduction studies, cranial MRI or CT
Vagus nerve lesion	Hoarseness, difficulty swallowing, loss of gag reflex, uvula deviation toward the healthy side	Clinical history, neurological exam	Laryngoscopy, EMG, cranial MRI or CT
Lower motor neuron lesion of the hypoglossal nerve	Tongue atrophy, fasciculations, tongue deviation toward the affected side	Clinical history, neurological exam	EMG, nerve conduction studies, cranial MRI or CT
Upper motor neuron lesion of the hypoglossal nerve	Tongue weakness without atrophy, spasticity, difficulty articulating words	Clinical history, neurological exam	Brain MRI, functional neuroimaging studies