Neck-tongue syndrome is a rare syndrome characterized by altered sensation in one side of the tongue with ipsilateral neck pain triggered or aggravated by rotatory neck movement.
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Epidemiology
Neck tongue syndrome is seen in a wide range of ages but is most commonly reported in older children, adolescents and young adults 1-4.
Clinical presentation
Patients present with episodic, often severe, upper cervical and occipital pain with associated symptoms in the ipsilateral tongue, including numbness, pseudoathetosis, dysarthria, and lingual paralysis. Rotatory neck movement triggers or aggravates symptoms 1-4. Episodes of pain and discomfort last from seconds to short minutes 4.
Pathology
Neck tongue syndrome is believed to be due to damage to lingual afferent fibers traveling in the hypoglossal nerve to the C2 spinal roots, possibly due to subluxation of the lateral C1/2 joints 1-3. It is divided into 3:
complicated neck-tongue syndrome: underlying disease process (inflammatory or degenerative) can be identified
uncomplicated neck-tongue syndrome: idiopathic or trauma-related
Treatment and prognosis
Treatment is generally with physical therapy, although medications (e.g. amitriptyline, gabapentin, etc.) have also been used 4.
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