Numb Tongue And Lips

Numb Tongue and Lips: Causes and Insights

Thalamic Hemorrhage and Sensory Disturbances

Numbness in the tip of the tongue and lower lip can be a result of a thalamic hemorrhage, particularly involving the ventroposteromedial (VPM) nucleus. This condition was observed in a 62-year-old hypertensive man who experienced severe numbness in the left tip of the tongue and ipsilateral lower lip. The somatosensory impulses of the tongue are conveyed via the lingual nerve to the contralateral medial VPM proper, indicating that a stroke in this area can lead to such sensory disturbances.

Hypoglossal Schwannoma and Lip Numbness

Another rare cause of numbness in the tongue and lips is a hypoglossal schwannoma. This condition can present with hemi-atrophy of the tongue and numbness in the lip. A case study reported a patient with a lobulated mass in the right posterior fossa extending to the right upper neck, confirmed as a schwannoma through pathological studies.

Neck-Tongue Syndrome

Neck-tongue syndrome is characterized by unilateral upper nuchal or occipital pain accompanied by ipsilateral numbness of the tongue. This syndrome is explained by the compression of the second cervical root in the atlantoaxial space during sharp neck rotation. The lingual nerve fibers traveling via the hypoglossal nerve to the second cervical root provide a plausible anatomical explanation for this phenomenon .

Burning Mouth Syndrome (BMS)

Burning Mouth Syndrome (BMS) is another condition that can cause numbness in the tongue and lips. BMS is characterized by burning pain, tingling, or numbness in the oral mucosa, often affecting the tongue, anterior palate, and lips. The condition has a multifactorial origin, involving peripheral nerve dysfunction, hormonal imbalances, and psychological factors. Treatment options include systemic alpha-lipoic acid, clonazepam, and psychotherapy .

Post-Surgical Numbness

Numbness of the tongue can also occur after otologic procedures, particularly middle ear surgery. This numbness is often associated with the chorda tympani nerve, which confers general sensation from the tongue. A study found that 47% of patients undergoing middle ear surgery experienced numbness or tingling of the tongue, with significant reductions in sensitivity to light touch and 2-point discrimination on the operated side.

Dental Procedures and Lingual Nerve Injury

Lingual nerve injury during dental procedures, such as the injection of anesthetics, can lead to prolonged numbness of the tongue. A case study described a 47-year-old woman who experienced tongue numbness for more than a year after a routine dental procedure. The numbness was consistent with lingual nerve injury, which can be caused by injection needles, anesthetic toxicity, or procedural manipulation.

Sialolithiasis and Lingual Nerve Compression

Intermittent compression of the lingual nerve due to sialolithiasis can also cause episodic unilateral numbness of the tongue. Removal of the obstruction has been shown to relieve symptoms, as reported in a case study.

Conclusion

Numbness in the tongue and lips can arise from various conditions, including thalamic hemorrhage, hypoglossal schwannoma, neck-tongue syndrome, burning mouth syndrome, post-surgical complications, dental procedures, and sialolithiasis. Understanding the underlying causes and mechanisms is crucial for accurate diagnosis and effective treatment.

Summary

Not a yes or no question