Tongue numbness causes
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Neurological Causes of Tongue Numbness
Tongue numbness can be caused by central neurological events such as strokes. For example, a small hemorrhage in the thalamic ventroposteromedial (VPM) nucleus can result in severe numbness in the tip of the tongue and lower lip, even without other neurological symptoms. This occurs because the somatosensory impulses from the tongue travel through the lingual nerve and reach the contralateral medial VPM, so a stroke in this area can specifically affect tongue sensation. Central neurological involvement should be considered when numbness is restricted to the tip of the tongue and lip, especially if other causes are not apparent .
Neck-Tongue Syndrome and Cervical Nerve Involvement
Neck-tongue syndrome is a condition where sudden neck movement causes pain in the neck and numbness in the tongue. This is usually due to compression or irritation of the C2 nerve root as it passes behind the atlantoaxial joint. The syndrome can be triggered by abnormal subluxation of the joint, which impinges on the C2 ventral ramus, leading to simultaneous neck pain and ipsilateral tongue numbness. The lingual nerve’s proprioceptive fibers, which travel via the hypoglossal nerve to the C2 root, provide the anatomical explanation for this phenomenon. Cases have shown that symptoms can be managed with physical therapy, postural stabilization, or, in some cases, surgical intervention if there is persistent nerve compression 2349.
Peripheral Nerve Injury and Dental Procedures
Tongue numbness is a recognized complication of dental procedures, especially those involving injections near the lingual nerve. Injury to the lingual nerve during dental anesthesia or surgical manipulation can cause prolonged or even permanent numbness in the anterior two-thirds of the tongue. The numbness may persist for months or years, and recovery is variable. Other dental causes include nerve compression from endodontic procedures or sialolithiasis (salivary gland stones), which can intermittently compress the lingual nerve and cause episodic numbness 6810.
Chemotherapy-Induced Neuropathy
Certain chemotherapeutic agents can cause oral and perioral neuropathy, including tongue numbness. Platinum-based drugs, taxanes, vinca alkaloids, immunomodulatory, and alkylating agents are known to induce numbness, tingling, and hypersensitivity in the oral cavity. These effects are due to changes in nerve cell structure and function caused by the drugs. Healthcare providers should be aware of this potential side effect in patients undergoing chemotherapy .
Mandibular and Lingual Nerve Entrapment
Anatomical variations or pathological changes in the infratemporal fossa can lead to entrapment of the mandibular or lingual nerves. Compression of the lingual nerve can result in numbness, hypoesthesia, or even anesthesia of the tongue, as well as loss of taste in the anterior two-thirds. This can be caused by ossified ligaments, muscle contractions, or other structural abnormalities in the region. Dentists and surgeons should consider nerve entrapment when evaluating unexplained tongue numbness .
Conclusion
Tongue numbness can result from a variety of causes, including central neurological events like thalamic stroke, cervical nerve root compression (as in neck-tongue syndrome), peripheral nerve injury from dental procedures, chemotherapeutic neuropathy, and anatomical nerve entrapment. Accurate diagnosis requires careful consideration of the patient’s history, recent procedures, and associated symptoms to guide appropriate management and treatment.
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