Paresthesias of the pharynx: causes, symptoms, diagnosis, treatment

Paresthesias are disorders of sensitivity not associated with any external influence and are characterized by the occurrence of various, often unusual, externally unmotivated sensations, such as a sensation of ants crawling, numbness, stiffening of individual areas of the skin or mucous membrane, pain in the hair roots (trichalgia), a sensation of skin moisture, the movement of drops of liquid on it (hygroparesthesia). Various paresthesias are especially often observed in tabes dorsalis and other diseases of the nervous system, in which the roots of the sensory cranial nerves or the posterior roots of the spinal nerves are involved in the process.

In case of paresthesias occurring in the bucopharyngeal region, patients, as a rule, localize them in the tongue and pharynx, and often cannot give them a clear qualitative definition. When examining the patient, no obvious objective (organic) causes of paresthesia can be identified. Usually, such patients complain of a lump in the throat, burning, tingling, pain in various areas of the pharynx or oral cavity. The sensations can be insignificant or unbearable, depriving the patient of sleep and rest. These pains can radiate to the nasopharynx, ear, temporal region or larynx. The general (physical) condition of patients does not suffer, however, most of them experience varying degrees of neurosis-like states, irritability, as well as cancerophobia, fear of tuberculosis and other diseases known to them, which leads to an anxious and suspicious state, pessimism, etc. Often, psychogenic paresthesias are caused by some banal disease of the throat, which is not characterized by the sensations that the patient complains of.

The most common form of pharyngeal paresthesia is a sensation of unilateral pain in the lower parts of the pharynx at the level of the thyroid cartilage. The cause of most of the above-mentioned paresthesias is diseases of the lower teeth and periodontium, as well as an enlarged styloid process, which irritates the reflexogenic zones of the glossopharyngeal nerve with its end. Often, pharyngeal paresthesias are caused by diseases of the cervical spine.

A special place among the paresthesias of the oral cavity is occupied by pseudoalgic conditions of the tongue (glossodynia), the cause of which in the overwhelming majority of cases is individual hypersensitivity to the materials from which the plates of dental prostheses are made, as well as the presence of artificial teeth made of different metals that generate galvanic currents in the oral cavity.

Glossalgia often occurs with anemia and gastrointestinal diseases. Some glossalgias are accompanied by tongue atrophy, such as Gunther's glossitis, which occurs with pernicious anemia. Some forms of hypochromic anemia (essential or achylic, associated with stomach damage) may cause very pronounced changes in the oropharyngeal region with numerous concomitant lesions of other organs. An example of such a disease is Plummer-Vinson syndrome, which is manifested by hypochromic anemia and other changes in the formed elements of the blood, in which atrophy of the mucous membrane of the oral cavity, pharynx and esophagus with dysphagia, a burning sensation in the tongue, functional spasm of the esophagus and cardia, superficial glossitis and many other pathological phenomena in various parts of the body are observed. Diseases of the tongue such as glossodynia are observed in vitamin deficiency, especially with a deficiency of vitamin B6.

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