Burning at the tip of the tongue

Burning mouth syndrome (stomalgia, glossodynia, hypossalgia) is a burning sensation in the tip of the tongue or its lateral parts, which in severe cases covers the entire tongue, gums, palate, oral cavity. Usually this suffering is caused by hypothalamic dysfunction - congenital or acquired. Hypothalamic dysfunction causes increased activity of the sympathoadrenal system. The main clinical signs are:

• obligatory features:
  • paresthesia of the tongue (sensation of tingling, prickling, pressure);
  • coating on the tongue and dryness;
  • increased burning sensation after eating irritating food;
  • disappearance of burning sensation when eating non-irritating food;
• optional features:
  • small cracks on the tongue;
  • swelling of the tongue with teeth marks along the edges;
  • hypertrophy or atrophy of filiform papillae;
  • hypertrophy of the lymphatic follicles at the root of the tongue;
  • mild pain when palpating the tongue;
  • decreased taste sensitivity;
  • pain on palpation of the temporomandibular joints.

Differential diagnosis of this pathological condition must be carried out with:

• damage to the glossopharyngeal and lingual nerves, pterygopalatine ganglion, cervical nodes of the sympathetic trunk, which causes excruciating (rarely burning) paroxysmal pain in one half of the tongue spreading to surrounding tissues or the entire half of the face;
• glossitis, which is characterized by moderate pain during eating, talking, palpation; hyperemia and swelling of the tongue, plaque, areas of desquamation, erosion or ulcers;
• B12 and folate deficiency anemia, in which patients complain of pain and a burning sensation in the tongue and its characteristic changes: a bright red, smooth and shiny ("varnished") tongue.

[ 1 ], [ 2 ], [ 3 ]