An 80-year-old woman with a history of arterial hypertension, dyslipidemia, glaucoma, and breast cancer treated 10 years ago came to the neurology department with a right-sided hemicranial headache. The patient described oppressive pain of mild to moderate intensity, accompanied by slurred speech and slight difficulty chewing with no swallowing problems, which had been present for a month. She denied having reduced mobility or pain in the neck. Physical examination revealed right-sided tongue hemiatrophy with fasciculations and deviation, right side of the tongue on protrusion (Figure 1), and mild dysarthria; the rest of the neurological and systemic examination results were normal. She was diagnosed with right-sided isolated hypoglossal nerve palsy (CNXIIP).