The physical examination of sublingual nerve injury first reveals unilateral or bilateral tongue movement disorder, followed by tongue muscle atrophy and muscle bundle tremor; the mouth and lips are often weak and unable to puff, even when using fingers to press the nostrils closed often still can not puff the cheeks, only when pressing the lips to close the mouth puff. The palatal arch is paralyzed, and the sucking reflex is absent. Tongue muscle atrophy with or without tongue muscle tremor and abnormal brainstem reflexes. How to check for sublingual nerve injury? 1.Symptoms Patients with simple hypoglossal nerve injury may have some na-ache at the beginning, but no swallowing difficulty, and only when severe, there is obvious speech and swallowing disorder. With the posterior group of cerebral nerve injury at the same time, the performance is different, first occurring in rapid meals or drinking, speech and laughter during meals and drinking cause coughing and choking, and later swallowing disorders gradually aggravated, in quiet and general conditions of eating also have difficulties. The difficulty in swallowing can be caused by facial muscle paralysis, which makes the food easy to stay in the cheeks, tongue muscle paralysis, which makes the food move to the pharynx, and tongue muscle paralysis, which makes the entrance of the pharynx not fully closed when swallowing, and causes the food, especially liquid, to reflux out of the nostrils, and the transportation of food in the pharynx and esophagus is also slower and more difficult than normal. Finally, chewing is also difficult, and patients are unable to bite hard food and can only eat soft and semi-liquid food. Due to the difficulty in swallowing, food and large amounts of saliva are often retained in the mouth, causing frequent choking and coughing, but the cough is often weak. In the late stage of the disease, the mouth is open, saliva is in the mouth, speech and swallowing are not possible, and the patient must rely on a nasal feeding tube to maintain food intake. Eventually, death often occurs due to aspiration pneumonia, asphyxia and collapse. The earliest symptom of medullary paralysis is often a speech disorder, with speech easily fatigued, especially if the voice needs to be raised and the tone of voice increased. The first difficulty occurs with pharyngeal sounds, then tongue sounds, and finally laryngeal sounds, and this dysarthria gradually turns into nasal eating. 2.Signal examination Firstly, unilateral or bilateral tongue movement disorder is found, followed by tongue muscle atrophy and muscle bundle tremor; the mouth and lips are often weak and cannot puff, that is, using fingers to press the nostrils closed often still cannot puff, can only puff when pressing the mouth and lips closed. The palatal arch is paralyzed, and the sucking reflex is absent. Tongue muscle atrophy with or without tongue muscle tremor, abnormal brainstem reflex. 3.Laboratory examination CT scan, especially MRI examination, of tumor in craniocervical junction area can confirm the diagnosis of tumor in occipital foramen and upper cervical spinal cord, and can clearly show the adjacent relationship between tumor and medulla oblongata, cervical medulla and vertebral artery and posterior inferior cerebellar artery. CT scan of subungual neuroma shows occupancy of the pontocerebellar horn with image enhancement.