Lingual Nerve Injury
Lingual nerve injury is a common complication following dental and medical procedures. The clinical presentation of lingual nerve injury, its epidemiology, predisposing factors, and anatomy are explored in an attempt to identify those patients at risk for developing neuropathic pain. Nonsurgical and surgical therapies also are discussed.
Three years ago, a 24-year-old woman underwent local anesthetic blocks and removal of upper and lower molars by her dentist. She subsequently reported numbness and tingling of the left side of her tongue and the floor of her mouth that have persisted up to the present time. About 3 or 4 times per week, she experiences "aching and throbbing" in the same distribution, reduced but not relieved by naproxen. She also has had disturbance of taste since the procedure; she does not like the flavor of any type of meat and has become a vegetarian. Findings from the neurologic examination are normal, except for decreased pinprick sensation over the anterior two thirds of the left side of her tongue and the floor of her mouth. Three oral surgeons have seen her, all of whom recommended nonsurgical treatment.
Summary
Lingual nerve injury is a common complication following dental and medical procedures. The clinical presentation of lingual nerve injury, its epidemiology, predisposing factors, and anatomy are explored in an attempt to identify those patients at risk for developing neuropathic pain. Nonsurgical and surgical therapies also are discussed.
Case History
Three years ago, a 24-year-old woman underwent local anesthetic blocks and removal of upper and lower molars by her dentist. She subsequently reported numbness and tingling of the left side of her tongue and the floor of her mouth that have persisted up to the present time. About 3 or 4 times per week, she experiences "aching and throbbing" in the same distribution, reduced but not relieved by naproxen. She also has had disturbance of taste since the procedure; she does not like the flavor of any type of meat and has become a vegetarian. Findings from the neurologic examination are normal, except for decreased pinprick sensation over the anterior two thirds of the left side of her tongue and the floor of her mouth. Three oral surgeons have seen her, all of whom recommended nonsurgical treatment.
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