Numbness On Tongue Tip

Numbness on Tongue Tip: Causes and Insights

Thalamic Hemorrhage and Tongue Numbness

Numbness in the tip of the tongue 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 his tongue and ipsilateral lower lip. The somatosensory impulses of the tongue are conveyed via the lingual nerve and reach the contralateral medial VPM proper via the trigeminal spinal nucleus. Therefore, a thalamic stroke affecting the medial VPM proper can lead to numbness in the tongue tip.

Hemispheric Stroke and Sensory Disturbance

Isolated numbness at the tip of the tongue can also be associated with hemispheric strokes. In a case involving a hypertensive woman, recent small infarctions were found in the postcentral gyrus of the right parietal lobe, leading to isolated numbness at the tongue tip. This highlights the importance of considering central neurological involvement in cases of sensory disturbances at the tongue tip.

Dental Procedures and Lingual Nerve Injury

Lingual nerve injury is a common cause of tongue numbness following dental procedures. A case study described a 47-year-old woman who experienced prolonged numbness in the anterior two-thirds of her tongue after a routine dental procedure involving lingual nerve injections. The numbness persisted for more than a year, indicating potential nerve damage from the injection needles, anesthetic toxicity, or procedural manipulation. Additionally, transient lingual nerve injuries have been reported following the use of laryngeal mask airways during surgeries, with patients typically recovering within two weeks.

Anatomical Considerations and Surgical Implications

The lingual nerve's course and distribution in the ventral tongue region are crucial for understanding potential numbness following surgical procedures. Anatomical studies have shown that the lingual nerve innervates the tongue tip, and surgical manipulations in this area can damage the nerve, leading to numbness. This information is vital for performing safe surgical procedures such as frenectomies.

Neck-Tongue Syndrome

Neck-tongue syndrome is characterized by unilateral upper nuchal or occipital pain accompanied by ipsilateral numbness of the tongue. This condition is caused by compression of the second cervical root in the atlantoaxial space during sharp neck rotations. The lingual nerve's afferent fibers travel via the hypoglossal nerve to the second cervical root, explaining the numbness in the tongue .

Otologic Procedures and Chorda Tympani Nerve

Patients undergoing middle ear surgery often report numbness of the tongue, which may be due to the involvement of the chorda tympani nerve. This nerve is responsible for general sensation from the tongue, and its involvement during otologic procedures can lead to temporary sensory disturbances.

Conclusion

Numbness at the tip of the tongue can result from various causes, including thalamic hemorrhage, hemispheric strokes, dental procedures, surgical manipulations, neck-tongue syndrome, and otologic procedures. Understanding the underlying mechanisms and anatomical considerations is crucial for accurate diagnosis and effective management of this condition.

Summary

Not a yes or no question