VASENEV E. E.
Medical Academy, Volgograd
Sometimes practical dentists or neuropathologists have to deal with various pain syndromes in the oral cavity. These include pain dysfunction of the temporomandibular joint, various disorders in the trigeminal and facial nerve system, as well as such a common disease as glossalgia. Glossalgia — a long-term disease that often leads to personal disorganization of middle-aged and elderly patients. This makes the problem of glossalgia not only medical, but also social.
The prevalence of this disease, according to various researchers, ranges from 14% to 26% among patients with facial pain. Unfortunately, the incidence of glossalgia has not decreased in recent years, but on the contrary has increased. This is probably due to the increasing role of stressful events as psychopathological causes of glossalgia.
Due to the polymorphism of clinical manifestations of glossalgia, this pathology is found in the literature under different names: stomalgia, glossodynia, glossopyrrhosis, neurosis of the tongue, burning mouth syndrome and others.
Symptoms of glossalgia
Glossalgia affects menopausal women and older. The disease occurs three times more often in women than in men. Patients turn to doctors with complaints of constant unpleasant sensations in the tongue or on the mucous membrane of the oral cavity (from mild tingling to unbearable burning). A pathognomonic sign for glossalgia is a significant decrease or disappearance of pain during meals and sleep. Patients are worried about unbearable discomfort, various phobias. Many people constantly look at the language in the mirror, which soon becomes a habit. On this basis, carcinophobia develops.
If the diagnosis of glossalgia does not cause doctors any difficulty, then the lack of sound methodological approaches to treatment often puts practitioners at a dead end. Unfortunately, the currently used drug therapy of glossalgia is not always effective and requires a lot of patience from both the doctor and the patient. Various groups of drugs are currently used in the complex treatment of the disease: psychotropic, vegetotropic, vasoactive and desensitizing drugs, vitamins.
Treatment of glossalgia
Locally prescribed rinses and applications with herbal preparations (infusion of chamomile, sage, calendula, citral solution, sea buckthorn oil, etc.), which have analgesic, anti-inflammatory and wound healing effect. A significant role in the treatment of glossalgia is assigned to physiotherapy procedures: massage of the collar zone, electrophoresis, radiation of a helium-neon laser, etc. However, such a voluminous complex program has obvious drawbacks. These include difficulties in the individual choice of medications and the possibility of side effects (allergic reactions, drug addiction and addiction), as well as the inability to perform some physiotherapy due to common diseases in patients. All this requires the search for new methods and methodological approaches in the treatment of glossalgia.
A possible solution to this problem was the introduction of a new non-drug method of anesthesia into practical medicine — transcranial electrical stimulation. The essence of this method of treatment is a mild effect on the analgesic structures of the brain and the elimination of disturbing vascular reactions. As a result, the severity of the pain syndrome is significantly reduced and, as a result, the general condition of patients is improved. Transcranial electrostimulation has been used at the Department of Therapeutic Dentistry of the Volgograd Medical Academy for four years to treat patients with glossalgia with various background pathology. During this time, 69 patients underwent treatment.
As the results of treatment showed, 56.7% of patients had a complete disappearance of pain and paresthetic sensations in the oral cavity, 39% of patients had a decrease in the intensity of pain. The patients underwent glossalgia treatment using the Transair-2 transcranial electrical stimulation apparatus. The therapeutic effect was usually observed at 5-6 procedures, while patients noted the disappearance of pain during the procedure and for some time after it. The duration of the “light” interval increased with each procedure. As a rule, patients tolerated electrical stimulation very well.
The pronounced sedative effect of the electric procedure also had a general relaxing effect. After the procedure, the patients felt rested, their mood improved. After the course of electrostimulation, all patients showed an improvement in their general condition, which was expressed in normalization of sleep, increased activity and emotional tone. There were no general or long-term complications from the use of transcranial electrical stimulation.
However, our studies have shown the greatest effectiveness of this method of treatment in combination with medication. Transcranial electrical stimulation made it possible to abandon many drugs and significantly reduce the dosage of psychotropic drugs.
Long-term results of treatment were followed for 3 years. During this time, remission was observed for 1 year in 27 patients and over 3 years in 2 patients.
The simplicity of the method of application, significant effectiveness, absence of side effects and economic benefits from the use of transcranial electrical stimulation suggest that this methodological approach is an alternative to existing in the treatment of such a persistent and painful disease as glossalgia.
