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Tongue Signs

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The tongue is heavily innervated and plays a central role in articulation, swallowing, and tasting. Unilateral weakness is usually well tolerated. Intermittent weakness of the tongue is highly indicative of myasthenia gravis (MG), while progressive weakness and atrophy is typical for amyotrophic lateral sclerosis (ALS). Tongue weakness without atrophy or fasciculations is a sign of upper motor neuron (UMN) or cerebellar involvement. Lingual dysarthria should be differentiated from other types of dysarthria. Tongue tremor is common and may be confused with fasciculation. Inspection of the tongue while resting in the mouth is more telling than a contracted and protruded tongue for the presence of fsciculations. Direct needle examination of the tongue is painful and is rarely needed.
Oxford University Press
Title: Tongue Signs
Description:
The tongue is heavily innervated and plays a central role in articulation, swallowing, and tasting.
Unilateral weakness is usually well tolerated.
Intermittent weakness of the tongue is highly indicative of myasthenia gravis (MG), while progressive weakness and atrophy is typical for amyotrophic lateral sclerosis (ALS).
Tongue weakness without atrophy or fasciculations is a sign of upper motor neuron (UMN) or cerebellar involvement.
Lingual dysarthria should be differentiated from other types of dysarthria.
Tongue tremor is common and may be confused with fasciculation.
Inspection of the tongue while resting in the mouth is more telling than a contracted and protruded tongue for the presence of fsciculations.
Direct needle examination of the tongue is painful and is rarely needed.

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