Tongue Stroke Symptoms

Tongue Stroke Symptoms: An Overview

Common Tongue Symptoms in Stroke Patients

Numbness and Sensory Disturbances

Numbness in the tongue, particularly at the tip, can be a symptom of a stroke, especially when the thalamic ventroposteromedial (VPM) nucleus is involved. This type of stroke can cause severe numbness in the tongue and lower lip, as seen in a 62-year-old hypertensive patient who experienced acute numbness in the left tip of the tongue and ipsilateral lower lip due to a small hematoma in the medial part of the right thalamus. This sensory disturbance is attributed to the somatosensory impulses conveyed via the lingual nerve to the contralateral medial VPM proper.

Tongue Deviation

Tongue deviation is another notable symptom, often resulting from brain stem strokes. This occurs due to muscle weakness on one side of the tongue, controlled by the hypoglossal nucleus and its supra-nuclear innervation. For instance, an 81-year-old male patient exhibited right-sided hemiparesis, right lower facial droop, dysarthria, and tongue deviation to the right side without fasciculation or atrophy, indicating a left paramedian pontine infarction. The direction of tongue deviation can help localize the brain lesion, as it reflects the involvement of cortico-hypoglossal fibers and corticospinal fibers prior to their decussations.

Impact on Oro-Facial Functions

Impaired Masticatory Performance and Dysphagia

Stroke can significantly impair oro-facial functions, including masticatory performance and swallowing. Reduced tongue forces and disturbed oral sensitivity are common, leading to difficulties in chewing and swallowing. Stroke patients often exhibit facial asymmetry, reduced lip restraining forces, and impaired tongue-palate contact during swallowing, which collectively reduce oral health-related quality of life (OHRQoL). Rehabilitation efforts should focus on improving the strength and coordination of the oro-facial musculature to enhance these functions and prevent malnutrition.

Tongue-to-Palate Resistance Training (TPRT)

TPRT has been shown to improve tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia. A study involving a 4-week TPRT program demonstrated significant improvements in tongue strength and swallowing function in the experimental group compared to the control group, which only received traditional dysphagia therapy. This suggests that TPRT is an effective and simple rehabilitation strategy for enhancing swallowing in post-stroke dysphagia patients.

Traditional Chinese Medicine (TCM) Perspective

TCM Symptoms and Tongue Diagnosis

In Traditional Chinese Medicine (TCM), tongue diagnosis is a crucial tool for assessing stroke risk and progression. Common TCM symptoms in high-risk stroke groups include blurred vision, irritability, and dizziness, while tongue characteristics often observed are white moss, thin moss, and dark or red tongues. TCM practitioners use these indicators to differentiate syndromes and tailor treatments accordingly. Tongue diagnosis helps predict the progress and prognosis of stroke, providing valuable insights into the patient's condition and guiding preventive health care.

Conclusion

Tongue symptoms such as numbness, deviation, and impaired function are significant indicators of stroke and its impact on oro-facial health. Understanding these symptoms and incorporating effective rehabilitation strategies like TPRT can greatly improve the quality of life for stroke survivors. Additionally, TCM offers valuable diagnostic tools that can aid in the early detection and management of stroke, emphasizing the importance of a holistic approach to stroke care.

Summary

Not a yes or no question