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Oral Somatosensory Testing: could be a point to consider?
Dear Colleagues,
Nice to see a lot of discussion happening here.
This is regarding one of my patients with the complaint of Tongue numbness (especially while on the bed lying down on the left side. The left side of the tongue has numbness) recently who has a coexisting neck and facial pain too.
From your experience so far can you please suggest if you had come across any similar patient complaints and could the SST can be applied to this patient? If so How? as there isn't any mapping done to the Oral regions (as far as I know) in the Atlas.
I had searched in literature to find the available sources related to this and came across the attached article. Kindly go through and let me know your suggestions.
Comments
Dear Joshua from Bangalore,
I hope that evrything is laright to you and your family.
I was late to answer because, at first, I need to look in our database.
On 3768 patients we tested only 2 of them for a tongue numbness (stage I of A-bêta axonal lesions).
One presented a numbess of the hemi tongue:
lingual nerve RIGHT.
The second one presented a numbness of the whole distal part of the tongue:
lingual nerve LEFT & lingual nerve RIGHT.
I am writing about the distal part of the tongue, because the territory of cutaneous origin of the PROXIMAL part of the tongue is innervated by the glossopharyngeal nerve (IX). Of course, this part of the body is impossible to be either tested or stimulated.
Once I welcomed a man with a glossodynia and I don't even tried to propose to him any treatment.
The result of the lingual nerves ?
One patient accepted our treatment and was successful.
The second one accepted only an assessment and refused to stard the soamtosensory Rehabilitation.
I hope that these few informations are going to help you a bit
With my best regards
CJ
Dear Claude
Thank you so much for the response.
Yes myself and family are doing alright. Hope the same at your end as well.
Thanks for the inputs regarding the 2 unique case scenarios among the huge 3768 patients database.
Its surely a point to consider.
I ve also tested and started the treatment with some additional inputs.
However wanted to know some more details in to the innervation as to whether the tongue and cutaneous innervation are similar to expect the testing or treatment outcomes on similar lines or otherwise.
Plus demarcating which nerve is affected?
Could there be a trigeminal nerve involvement too?
Implication of this thread: May be considering a point to include the oral somatosensory mapping (atleast briefly) in the atlas can be a future prospect too.
Thanks again for the detailed reply. Its sure helpful.
Regards
Joshua R
Hi Joshua,
Please accept my apologize for the delay of my answer.
I'm actually treating a patient who describes painful feelings on the cheek, the lips, the tongue and the roof of her mouth. At first, we've treated touch-evoked pain on the cheek and lips (mandibular nerve, branch of trigeminal nerve), sucessfully. Now, she can touch her cheek, but still feels "flashing" when she touches the roof of her mouth. However, she says that the "dull" feeling on her tongue is now only at the tip of the tongue, and not on all he left part of the tongue anymore.
I told her that I didn't know how far we would be able to improve her feelings, but she's quite happy that she can already touch her cheek and lips again.
She has started an osteopathy treatment for the neck in parallel since the allodynia disappearance.
Let us know how things are evolving with your patient
Kind regards
Florine