GLOSSODYNIA (glossalgia; grech, glossa language + algos pain; synonym glossodynia) — the clinical syndrome which is shown burning, a pricking, an itch in language and other feelings of paresthesia.
On observations of most of authors, G. accompanies a number of diseases. In 80 — 90% of cases diseases are found in sick G. went. - kish. path (gastritis, peptic ulcer, cholecystitis, colitis, helminthic invasion); It is observed at pernicious anemia, a late chlorosis, disorder of function of generative organs (especially at a climax), functional and organic lesions of vegetative and central nervous systems. In 14 — 17% of cases so-called reduced is found bite (see). Accompanies sometimes some forms of a glossitis (geographical, folded, rhomboid, black hairy language), red flat deprive, Candidiasis of a mucous membrane of an oral cavity; can arise at osteochondrosis of cervical department of a backbone.
The etiology and a pathogeny
the Aetiology and a pathogeny are finally not found out. A. G. Zhukova (1972) observations and kliniko-pilot studies of E. S. Yavorskaya (1974) allowed to allocate some specific links of a pathogeny that gave them the grounds to carry out differentiation of a glossodynia with a glossodynia. However most of authors continues to consider the terms «glossodynia» and «glossodynia» synonyms. A. G. Zhukova and E. S. Yavorskaya consider that in genesis of a glossodynia the leading place belongs to organic and functional disturbances of various departments of c. N of page — sensitive and motive kernels of pontobulbarny department of a trunk of a brain, bulbospinalny kernels of a trifacial, a reticular formation of a myelencephalon; dysfunction of sympathetic and parasympathetic parts of the nervous system is more characteristic of genesis of a glossodynia. Changes of a nervous system are quite often accompanied by visceral pathology; at the same time the frequency of detection at patients with a glossodynia and glossodynia of diseases of digestive organs is explained by an anatomic and functional linkage of a kernel of the vagus nerve innervating went. - kish. a path, with a kernel of a trifacial.
Complaints of patients and intensity of subjective feelings vary over a wide range. Quite often paresthesias of a mucous membrane of cheeks, the sky, lips, skin of infraorbital and mental areas join. Flavoring sensitivity can be lowered, the food faddism is possible. Paresthesias depress mentality of patients, at part of them the cancerophobia develops. Persons suffer, as a rule, 40 years are more senior and women are more often.
Caries, incorrectly filled tooth and prostheses, a dental calculus, galvanic currents at prostheses from diverse metals, an injury of language, the irritating food, some drugs can be the contributing and provocative factors.
Develops gradually. In the beginning the phenomena of paresthesia are short-term; over time attacks repeat, their intensity and duration increase, especially by the evening, after the long conversation, at stressful situations. Intensity of paresthesia is disproportionate to changes of a mucous membrane of language. A mucous membrane of language if G. does not accompany to a glossitis (see), it is not changed in the beginning, but the small atrophy of nipples of language and a hyperplasia limf, follicles is sometimes observed. It is gradually possible to find a hypertrophy of leaflike and zhelobovidny nipples, puffiness, a phlebectasia on a lower surface of language, decrease in salivation.
G.'s phenomena can last in one cases months, in others — years; sometimes without treatment there occur remissions, but through a nek-swarm time arises an aggravation again.
the Diagnosis to make the diagnosis sometimes can be difficult: comprehensive, comprehensive examination of the patient, taking into account complaints, visible changes of language, detection of diseases of other bodies and systems is necessary.
Differential diagnosis It is necessary to carry out with organic lesions of language, an inflammation and a tumor. The main difference consists that at G. there are no objective signs of changes of fabrics of language or there are only insignificant disturbances not capable to cause pains and paresthesia. Differentiate also with neuralgia of lingual and glossopalatine nerves of which the acute pristupoobrazny pains on one party of language irradiating into the sky, bays, almonds and amplifying at a conversation, the movement by language are characteristic; localization of pain at neuralgia corresponds to topography of the innervated zone.
First of all — treatment of the revealed basic disease, at a cancerophobia — psychotherapy, sedatives. At disturbances of a bite — prosthetics. In the beginning at emergence of complaints before establishment of the reason of G. symptomatic therapy is possible: the anesthetizing rinsings, lotions of 1% of solution of novocaine, vitamins of group B, elimination of the local irritating factors, a sparing diet. For stimulation of salivation — vitamin A, 5% solution of potassium iodide inside, 1% solution of Pilocarpinum on 5 drops on reception. At identification of vegetative frustration — galvanization, a diathermy of parotid sialadens and upper cervical sympathetic nodes. At very expressed paresthesia — novocainic blockade as mandibular anesthesia (see. Anesthesia local, anesthesia of maxillofacial area ), in certain cases alcoholization (see) or introduction of 3 — 5 ml of 1% of solution of Spasmolytinum to area of a lingual nerve; ultrasound or diadynamic currents of Bernard on area of language, darsonvalization, an electrophoresis of sodium, an electrosleep.
Forecast favorable at successful treatment patol, the states which caused. Elimination of the local irritating factors improves a condition of sick, heavy frustration does not happen, working capacity is not broken.
Bibliography Bohr E. V., Groshikov M. I. and Patrikeev V. K. Therapeutic stomatology, page 342, M., 1973; Gurkina K. I. both Dombrovsky N. S. Klinika and treatment of glossodynias, Doctor, business, No. 9, page 81, 1966; D r about z-dovaz. And. isamoylovar. G. O pathogeny and treatment of paresthesias of language, Stomatology, JSIa 5, page 17, 1960; Palkin I. I. Nazoreflektornaya a technique of an electrophoresis of bromine and experience of its use at treatment of a glossalgia, in the same place, JSS 1, page 89, 1963; Yavorskaya E. S. Topography of paresthesias at a glossodynia, the Doctor, business, JsTs 10, page 55, 1965.
A. I. Marchenko.