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Abstract Details

Pseudo Orofacial Lingual Dyskinesia as a Manifestation of Burning Mouth Syndrome
P9 - Poster Session 9 (5:30 PM-6:30 PM)
Tongue and mouth movements which present as OFLD, but consciously produced due to self-soothing in Burning Mouth Syndrome (BMS), has not heretofore been reported.
To highlight orofacial lingual dyskinesia-like movements (OFLD) may be due to oral pain.
Case Study: This 64-year-old right-handed male underwent a dental procedure where his tongue was accidentally lacerated. Over the next four months, a burning-like sensation spread to involve the entire tongue, was constant, 5/10 in severity reduced by tongue movements. He found throughout the day he moved his tongue vigorously to stop the pain. He would slither his tongue through his mouth hundreds of times a day. He was conscious of the movement, knew he was doing it “as a habit,” and was able to stop it, but because of the pain, he would restart it.
Continuous movements of the tongue which upon request by the examiner would stop.
Movement of the tongue induces activation of large nerve fibers which, through Melzack and Wall’s Gate Control Theory of Pain, inhibit the discharge of the smaller unmyelinated nerve fibers which mediate the pain of BMS (Melzack, 1965), this serving as a nidus for habitual movement of the tongue, thus manifesting as OFLD. Activation of such large nerve fibers may be the mechanism of action for the effectiveness of tongue protectors to reduce burning mouth syndrome or magnesium hydroxide suspension rinse to reduce BMS (Gurvits, 2013; Hirsch, 2009). Such reduction of pain, served as a nidus for the habitual movement of the tongue manifesting as OFLD. Unlike true OFLD, the current patient consciously produced tongue movements and thus is more appropriately classified as a habit. In those with OFLD, it would be worthwhile to assess the presence of BMS to determine if treatment of this may reduce any adventitious movements.
Sunjeet Brar
Miss Brar has nothing to disclose.
Alan R. Hirsch, MD, FACP (Illinois Center for Neurologial and Behavioral Medicine, Ltd.) Dr. Hirsch has nothing to disclose.