Numbness Of The Tongue : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 30/08/2022

Numbness of the tongue is noted with glossalgia, glossodynia, desquamative glossitis, injuries, tumors, and inflammatory processes in the maxillofacial zone. Sometimes it occurs as a result of taking medications, medical manipulations, parasitosis, neurological diseases, mental disorders. It may be temporary or permanent, covering all or part of the language. To establish the causes of numbness, a survey, dental examination, ultrasound, electromyography, microscopy and bacteriological examination of the tongue scraping are prescribed. In the treatment, sedative and anti-inflammatory drugs, vitamins, antihistamines are used.

Why is the tongue numb

External causes

Short-term numbness of the tongue is provoked by the use of certain foods. The tip of the tongue is often numb in heavy smokers. Sometimes a symptom occurs at the time of taking strong alcoholic beverages, in a state of intoxication. In young children, a temporary decrease in sensitivity may be due to compression of the tongue when trying to stick it into small cavities, such as a tube or a designer element.

Dental manipulations

The tongue becomes numb for a short time after dental anesthesia; normally, sensitivity is fully restored after a few hours. If the rules of the procedure are violated, the symptom may persist for a long time. Long-term paresthesias are sometimes observed after the removal of wisdom teeth, near which branches of sensory nerves pass.

Constant numbness often worries people with metal prostheses and fillings. The reason is the interaction of several metals in a liquid medium. Under the action of saliva, a galvanic current is produced, which irritates the mucous membrane, provokes paresthesia and numbness.

Other medical effects

Taking medicines with anesthetics (throat sprays, bellastezin, which eliminates stomach pain) causes numbness of the tongue lasting up to several minutes. More severe reactions are formed with the development of neurological complications of local anesthesia due to the absorption of a large amount of the drug or its erroneous injection into a vein. Numbness of the tongue and oral cavity is complemented by dizziness, metallic taste, ringing in the ears, tremor. Convulsions, disturbances of consciousness and speech are possible.

When carrying out behind-the-ear blockade, numbness of the tongue is observed in the norm, it is a marker indicating that the needle has hit the right place. It can persist for a day after the procedure, combined with slight dizziness. Prolonged or permanent violation of sensitivity sometimes becomes the result of operations on the ENT organs and facial structures, is associated with compression or mechanical damage to the nerves.

Numbness of the tongue

 

glossalgia

It is manifested by constant or periodic numbness, soreness, tingling, burning of the tongue. Symptoms become more pronounced during conversation, with excitement and overwork, decrease during meals. The tongue and oral mucosa were not changed. Glossalgia is a functional disorder that often develops in patients with neurosis, depression, psychosomatic diseases. Secondary glossalgia is provoked by the following conditions:

  • Diseases of the digestive system : gastritis, cholecystitis, hepatitis, pancreatitis.
  • Endocrine pathologies : hypothyroidism, Itsenko-Cushing's disease, diabetes mellitus.
  • CNS damage : condition after ischemic or hemorrhagic stroke, encephalitis, meningoencephalitis, neurosyphilis.
  • Diseases of peripheral nerves : sympathalgia, damage to the sublingual autonomic node and glossopharyngeal nerve.
  • Connective tissue diseases : dermatomyositis, scleroderma.

glossodynia

Numbness, burning, tingling, itching, crawling sensation and the presence of hair is bilateral in nature, occurs at the tip or anterior 2/3 of the tongue, less often in the root area. At the initial stage, the attack lasts several minutes. With a long course, the zone of unpleasant sensations increases. Severe paresthesias persist for several hours, even outside an attack, patients are worried about constant discomfort. Hyposalivation is often observed. Glossodynia is caused by:

  • Gastrointestinal diseases : colitis, gastritis, cholecystitis, pancreatitis, peptic ulcer.
  • Endocrine disorders : diabetes mellitus, thyroid pathology.
  • Pathologies of the heart and blood vessels : ischemic heart disease, hypertension, atherosclerosis.
  • Diseases of the nervous system : vegetative-vascular dystonia.

Desquamative glossitis

The disease can be asymptomatic or accompanied by numbness, tingling, burning. Areas of whitish-gray plaque are formed on the tongue, in place of which red or bright pink smooth spots form. The affected areas are quickly covered with epithelium, they are replaced by other foci, so the appearance of the tongue is constantly changing.

Nervous diseases

Numbness of the anterior sections of the tongue develops when the third branch of the trigeminal nerve is damaged, the posterior sections - the glossopharyngeal nerve, the root - the vagus nerve. The cause of damage is trauma, compression by a tumor or inflammatory infiltrate, germination of malignant neoplasia. Radiation neuralgia is possible after irradiation for oncological processes. In addition, a violation of the sensitivity of the tongue is detected in the following diseases of the nervous system:

  • Stroke. The symptom appears suddenly, complemented by muscle weakness and sensitivity disorders of half of the body, speech disorders, facial asymmetry.
  • Epilepsy. Numbness of the tongue is found in the composition of the aura before partial seizures. May be associated with dizziness, weakness, nausea, drowsiness, chest pain, ringing and noise in the ears, sensation of a lump in the throat.
  • Acute encephalopathy. Pathology is provoked by intoxications, dysmetabolic disorders. Manifested by numbness of the tongue, severe headache, unsteady gait, vomiting, visual disturbances.
  • Neurocardiogenic syncope. The symptom occurs before fainting, lasts no more than 2 minutes, is supplemented by nausea, dizziness, auditory and visual disturbances, anxiety, and a feeling of imminent fall.

Other reasons

The list of other pathological conditions accompanied by numbness of the tongue includes:

  • Parasitic diseases . The symptom accompanies many helminthic invasions, especially often found in ascariasis and acariasis.
  • Urgent conditions . Loss of sensation of the tongue is noted in victims with a delayed form of cyanide poisoning. Complemented by a metallic taste, pain and heaviness in the region of the heart. It is replaced by convulsions and subsequent paralysis.
  • Mental disorders . Numbness of the tongue sometimes occurs with panic attacks. Some patients with hysterical neurosis present complaints of paresthesia and sensory disturbances.

Diagnostics

The cause of numbness of the tongue is determined by the dentist. Patients with neurological symptoms are referred for a consultation with a neurologist. In the absence of manifestations of dental and neurological diseases, an extended examination is carried out with the involvement of a gastroenterologist, psychiatrist, and other specialists. For the diagnosis are made:

  • Dental checkup. The doctor assesses the condition of the tongue, reveals areas of desquamation of the epithelium, cracks, signs of inflammation. Examines the oral cavity for other changes, specifies the type of fillings and prostheses.
  • Neurological examination . With isolated pathologies, curtain and pharyngeal reflexes, excitability of the muscle fibers of the tongue are examined. In neurological diseases, a study of reflexes, muscle strength, sensitivity in various parts of the body is carried out.
  • Saliva Studies . The water indicator is determined using special strips. Measure the potential difference to detect galvanic currents. Subjects are prescribed sialography and ultrasound of the salivary glands.
  • Other instrumental techniques . With glossodynia and glossalgia, electromyography is performed. If you suspect a disease of the digestive system, an ultrasound of the abdominal cavity, gastroscopy is performed.
  • Laboratory tests . As part of a laboratory examination, microscopic and microbiological examination of saliva, general and biochemical blood tests, determination of the acidity of gastric juice can be performed.

Tongue examination

 

Treatment

Help at the prehospital stage

In most cases, urgent medical measures are not required. Exceptions are neurological pathologies and cyanide poisoning. In case of poisoning due to parenteral administration of cyanide to a limb, a tourniquet should be applied. The victims are shown the introduction of amyl nitrite, resuscitation to maintain vital functions.

Stroke patients are advised to lie on their side to prevent accidental aspiration of saliva and vomit. The probability of restoring neurological functions directly depends on the time of the start of treatment, so it is necessary to call an ambulance as soon as possible. When signs of an aura appear in an epileptic, the possibility of accidental injuries should be excluded.

Conservative therapy

In diseases of the tongue, sanitation of the oral cavity, treatment of provoking and supporting somatic diseases, a special diet, and sometimes psychotherapy are indicated. The scheme of drug therapy includes anti-inflammatory, antihistamines and sedatives, B vitamins, iron preparations, biostimulants. Rinsing with solutions of antiseptics and local anesthetics is effective.

With dry mouth, the tongue is lubricated with a solution of vitamin A in rosehip oil. According to indications, immunomodulators, medicines with antibacterial and antifungal effects are used. Nerve blocks are performed for patients with severe pain syndrome. These activities are supplemented with physiotherapeutic methods: ultrasound therapy, SMT therapy, ultraphonophoresis, drug electrophoresis.

Patients with neurological pathology, complications of local anesthesia from the side of the central nervous system are prescribed anticonvulsants, neuroprotectors, vitamin-mineral complexes, analgesics, antispasmodics, vasoactive agents. If necessary, carry out antibacterial therapy, detoxification. In case of poisoning, resuscitation measures are continued, neutralizing drugs, anticoagulants are used.

Surgery

With glossodynia, glossalgia and desquamative glossitis, surgical interventions are not indicated. The tactics of surgical treatment of patients with numbness of the tongue due to nerve damage is determined by the cause of the pathology. Opening of inflammatory infiltrates, removal of tumors, microsurgical decompression in case of scarring are possible.

In stroke patients, craniotomy, open excision, or stereotaxic aspiration of the hematoma may be recommended. In epilepsy, callosotomy, hemispherectomy, lobectomy and other techniques are used. In acute encephalopathy due to arterial occlusion, carotid-subclavian bypass, carotid endarterectomy, and vertebral artery prosthesis are performed.