Tongue muscle paralysis is commonly associated with stroke, a cerebrovascular accident. The facial and hypoglossal nerves, which innervate the inferior facial muscles, are damaged. Except for the facial nerve nucleus and the hypoglossal nerve nucleus, which innervate the subfacial muscles unilaterally (contralaterally), all other cerebral nerve motor nuclei receive fibers from bilateral cortical nucleus tracts. Damage to the upper motor neurons on one side may produce paralysis of the facial muscles below the fissure of the eye and the tongue muscles on the opposite side of the lesion, manifested by loss of the nasolabial groove on the opposite side of the lesion, drooping of the corners of the mouth and deviation to the side of the lesion, salivation, inability to perform cheek puffing and tooth exposure, and deviation of the tongue tip to the opposite side of the lesion when extending the tongue. In case of peripheral facial nerve palsy on one side, all facial muscles on the side of the lesion can be paralyzed, manifested as loss of frontal transverse lines, inability to close the eyes, drooping of the corners of the mouth and loss of the nasolabial folds. Damage to the motor neurons under the hypoglossal nerve on one side may result in paralysis of all the tongue muscles on the focal side, manifested as a deviation of the tongue tip to the focal side when extending the tongue. In individual cases of peripheral facial nerve palsy, a deviation of the tongue can be seen, in which case the tongue is always deviated to the healthy side. This is due to paralysis of the caudate lingualis and palatal lingualis muscles, which are innervated by the facial nerve. Routine examination of lingual muscle palsy: 1, X-ray and tomography: including X-ray of the skull, head and neck, cervical spine and tomographic X-ray of the jugular foramen area. 2.X-ray imaging (1) spinal iodine oil angiography; (2) subungual neuroma angiography; (3) carotid artery and/or vertebral artery angiography; (4) pneumoencephalography and spinal iodine water (oil) angiography for subungual herniation malformation of cerebellar tonsils. 3.CT and MRI: 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.