Oral Surg Oral Med Oral Pathol. Furrows that are longitudinal along the length of the tongue are the result of syphilis. Before BMC Res Notes. Describe the etiology and clinical manifestations of each of. The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. If the treatment is not successful, your healthcare provider may offer another diagnosis based on how your symptoms relate to another condition. Fissured Tongue Differential Diagnoses Updated: May 14, 2018 Author: Robert D Kelsch, DMD; Chief Editor: Jeff Burgess, DDS, MSD more. Neurology 1986;36:1406-7. http://library.med.utah.edu/neurologicexam/html/gait_abnormal.html#13, https://neurosigns.org/index.php?title=Tongue_deviation&oldid=466. You are examining a patient with sudden onset left-sided weakness. D, Lingual thyroid of the midline base of the tongue. New-onset macroglossia in an adult is pathognomonic for amyloidosis and should be treated as such until proven otherwise. On occasion, candidiasis also may coexist with geographic tongue.10, The diagnosis of geographic tongue and its treatment are based on the patients medical history and clinical examination. Stroke; Seizures/postictal paralysis . 2005 Jul. Please enable it to take advantage of the complete set of features! Before your provider makes a diagnosis, they will evaluate your symptoms by asking questions that go over your overall health and your medical history. According to the National Health and Nutrition Examination Survey (NHANES), the prevalence of tongue lesions at any given time is 15.5%.1 Many large scale, population-based screenings have identified the most common conditions affecting the tongue, however, these were performed on specific groups and the data may vary based on the population studied and assessment method.2,3. MeSH Due to the close association of geographic tongue in psoriatic patients, dentists are advised to inquire about skin problems in patients with geographic tongue, and refer these individuals for a skin evaluation if needed.11, Hairy tongue, also referred to as black hairy tongue or coated tongue, affects just 0.5% of the adult population.5 Amato Lusitano, a Portuguese physician, first described this condition in 1557.12 In a study conducted on 5150 Turkish dental patients, 11.3% presented with hairy tongue that included filiform papillae elongated more than 3 mm, and 23.2% exhibited hairy tongue in which the filiform papillae were less than 3 mm.3 In a study of 3611 Minnesota schoolchildren, however, prevalence of this condition was very low (0.05%).7 There is no gender predilection. Geographic tongue is a common accompaniment, and some authors believe that these 2 conditions are related. A differential diagnosis of fatigue includes but is not limited to: Symptoms of a headache include head pain that ranges in severity from mild to severe, a throbbing sensation and sensitivity to lights and sounds with symptoms that last for hours or up to several days. Although some investigators believe that geographic tongue is most common among children and that frequency decreases with age, others believe that it can occur at any age. We do not endorse non-Cleveland Clinic products or services. -, Neurocrit Care. Functional hemifacial spasm is seen in 2-6% of patients referred for specialist assessment of hemifacial abnormal movements, although more data are needed to establish the true frequency. Recurrent aphthous ulceration or stomatitis (RAU/RAS) occurs in some systemic illnesses. Dexterity is tested by having the patient repeat sounds involving the tongue, such as saying "la la la" or use words with "t" or "d" sounds. Paraganglioma tumors have specific features: CT: erosive and lytic bony destruction Damage to the hypoglossal nerve causes paralysis of the tongue. Key Diagnostic Features: Hemiatrophy of the tongue, with fatty replacement of the tongue muscles (high signal intensity on T1 and T2 and no enhancement), is one of the most important radiologic features of hypoglossal nerve palsy. Material and methods. 2000 Feb. 21(1):57-60. In this chapter, we describe the clinical characteristics of early- and advanced-stage OSCC and also consider the differential diagnosis of early-stage OSCC. Applicable To. The commonest acute causes of pain are dental and these are well managed by dentists. The three observable aspects of the tongue are strength, bulk, and dexterity. The condition is most frequently referred to as black hairy tongue (lingua villosa nigra); however, hairy tongue may also appear brown, white, green, pink, or any of a variety . In this article we summarise an approach to the assessment and diagnosis of functional symptoms in neurology, paying attention to those symptoms that are particularly "neurological", such as paralysis and epileptic-like attacks. Your healthcare providers goal is to treat the correct condition and not endanger you. The process to make an accurate diagnosis, especially with more complex conditions, can take time and doesnt happen immediately. Dermatologic Aspects of Addison Disease. The patient presents with painless, white plaques on the tongue or oropharynx which are easily scraped off. Pancreatitis. 2003 Jul-Aug;212(1-2):19-29 It causes speech and eating problems in some children. The apparent upper-motorneuron (UMN) signs in the limbs, together with the stiffness of the tongue, led us to a provisional diagnosis of pseudobulbar palsy. It is a nerve with a solely motor function. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2,3 Considering the safety of thrombolysis in stroke mimics (complication rate: 1.5%) 3 and its potential benefit in acute . Any lesion that cannot be easily or accurately diagnosed should be referred to a specialist for further evaluation. Federal government websites often end in .gov or .mil. Inflammatory bowel disease. The tongue is first observed for position and appearance while it is at rest. Video used by permission of Paul D. Larsen, M.D., University of Nebraska Medical Center and Suzanne S. Stensaas, Ph.D., University of Utah School of Medicine. While the exact etiology of geographic tongue is unclear, multiple causes have been proposed. [Pathologic changes in the tongue as signs of systemic diseases]. Abraham Verghese Asks: Why Are We Doing This Teaching? National Library of Medicine Gerressen M, Ghassemi A, Stockbrink G, Riediger D, Zadeh MD. 2009 Feb;29(1):45-52. doi: 10.1055/s-0028-1124022. Others theorize that oral lichen planus may be a reaction to medications or dental materials, or another allergic response but these theories are not supported by clinical evidence. Support Lucile Packard Children's Hospital Stanford and child and maternal health. Your symptoms increase in severity or go away. In patients with insulin-dependent diabetes, median rhomboid glossitis is one of the most commonly reported presentations of oral candidiasis.17, Clinically, median rhomboid glossitis is identified by a zone of depapillation of the filiform papillae, which manifests along the midline of the posterior dorsal surface of the tongue, anterior to the circumvallate papilla (Figure 4). [QxMD MEDLINE Link]. In rare instances, patients may experience a gagging sensation.5 Clinical examination with gauze or a dental instrument can help assess the elongation of the filiform papillae. The differential diagnosis of tongue swelling The differential diagnosis of tongue swelling Forensic Sci Med Pathol. A differential diagnosis of hypertension includes: Symptoms of knee pain include swelling around the knee, instability when standing, stiffness and popping noises when you move your knee. When refering to evidence in academic writing, you should always try to reference the primary (original) source. All you need to do is to stick your tongue out for a few seconds. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. It may seem overwhelming to see a list of possible conditions that might affect you, but remember that your differential diagnosis is not the final diagnosis. When you visit your healthcare provider with symptoms, they will begin a process to diagnose your condition. Semin Neurol. However, if there are associated symptoms such as difficulty with talking or swallowing, then a pathology should be ruled out. Other types of malignancies account for the small remaining 10%. Its association with autoimmunity is most plausible. and transmitted securely. Fast Five Quiz: What Do You Know About Dental Health? Am Fam Physician. 2023 Feb 15;439:114252. doi: 10.1016/j.bbr.2022.114252. Stanford Medicine 25 Skills Symposium 2015, Approach to Spinal Disease by Dr. Rick Hodes. After reading this course, the participant should be able to: Lesions affecting the tongue represent a substantial portion of oral mucosal lesions. Accessed 9/16/2021. This protocol is a cross-sectional, case-controlled observational study investigating the tongue features of non-dialysis CKD and end-stage renal disease patients by using the . Costa FW, Osterne RL, Mota MR, Alves AP, Soares EC, Sousa FB. The current term of approval extends from 7/1/2021-6/30/2023. A biopsy or culture may also aid the diagnosis. The image shows atrophy on the rt side of the tongue, and its deviation to the rt. Lateral medullary syndrome, also known as Wallenberg syndrome, is a clinical syndrome caused by an acute ischemic infarct of the lateral medulla oblongata . Lawoyin D, Brown RS. Multiple pages reviewed for this article. On rare occasions, a biopsy is required to confirm a histologic diagnosis.6 Because the majority of patients are asymptomatic and because geographic tongue is chronic or intermittent no treatment is generally indicated. Reamy BV, Derby R, Bunt CW. Tongue deviation in acute ischaemic stroke: a study of supranuclear twelfth cranial nerve palsy in 300 stroke patients. It is necessary in many functions, including the synthesis of both DNA, RNA and myelin production, particularly in the spinal cord. 1/Lin HC, Barkhaus PE. The frenulum of the tongue is a small fold of tissue that reaches from the floor of the mouth to the underside of the tongue. This is most typically in patients with some form of immunocompromise, particularly HIV, diabetes, or chronic antibiotic use, which leads to fungal overgrowth. The majority of our taste buds are in these papillae. 2,3 The differential diagnosis for masses of the tongue base includes normal lymphatic tissue, ectopic thyroid tissue, lymphoma, lipoma, hemangioma, schwannoma, granular cell tumors, benign and malignant tumors of minor salivary gland origin, rhabdomyosarcoma, and metastatic disease. Umapathi T, Venketasubramanian N, Leck KJ, et al. Previously, stress was considered to play a large factor in its etiopathogenesis. What medications, vitamins and/or supplements are you taking? Provider ID 317924. During a differential diagnosis, it might be daunting to see a list of possible conditions that could cause your symptoms. The process begins during an exam when they'll ask questions related to your condition including: Next, your healthcare provider will review your medical history to see if the symptoms connect to any previous health concerns or already diagnosed conditions. Cranial nerve palsies can be congenital or acquired. J Oral Maxillofac Surg. Diagnostic Considerations. Get useful, helpful and relevant health + wellness information. The prognosis is good. Authors Takahito Hayashi 1 , Michael Tsokos Affiliation Tongue movements are accompanied by up and down movement of the jaw for chewing and biting. We found dysarthria, and a stiff, small tongue, which deviated to the left on protrusion. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Microcopy Introduces the NeoDiamond X-Class, Zest Dental Solutions Launches Fully Guided Surgical Kit for Full-Arch Solutions, Ultradent Introduces J-Temp A Light-Cured, Premixed Temporary Resin. Alioglu Z, Caylan R, Adanir M, Ozmenoglu M. Melkersson-Rosenthal syndrome: report of three cases. Symptoms of abdominal pain include an ache, cramps or sharp pains at mild to severe levels localized to a specific area in your stomach region. The marked elongation of the filiform papillae makes them susceptible to discoloration and can present in varying shades, such as white, tan, brown or black (Figure 3).13 Darker discolorations are the result of entrapped debris, extrinsic staining from food, and chromogenic microorganisms in the filiform papillae.13 This condition may also be caused by a decrease in normal keratin desquamation.5 Because the filiform papillae are affected, this condition involves the mid-dorsal surface of the tongue, just anterior to the circumvallate papillae. Tongue lesions in a Jordanian population. Unable to load your collection due to an error, Unable to load your delegates due to an error. A differential diagnosis of chest pain includes: Symptoms of a cough include clearing your throat of mucus or fluids and clearing your throat of dry air, irritation or tickle in the back of your throat. Any deviation from this denotes a deviation from this ideal state of health and balance; the greater the deviation, the more severe the imbalance Tongue deviation was most common in patients with clinical features of the non-lacunar stroke subtype (56%) or in those with cortical or large subcortical infarctions on brain CT scan (55 and 45%, respectively). 2015 Jul;53(1):95-6. doi: 10.1016/j.pediatrneurol.2015.03.009. If you log out, you will be required to enter your username and password the next time you visit. tongue deviation differential diagnosis headaches. Ching V, Grushka M, Darling M, Su N. Increased prevalence of geographic tongue in burning mouth complaints: a retrospective study. FIGURE 2-1 Developmental anomalies. Contact your healthcare provider if you experience symptoms to diagnose and treat your condition. weakness, deviation of tongue to ipsilateral side Corticospinal nerve fibers in the "pyramid" Contralateral motor weakness Medial lemniscus Contralateral posterior column . A bright pink color on the tongue is most often due to a deficiency in iron, folic acid, or vitamin B-12. Belmont Publications, Inc. presents Decisions CE. 2012 Mar;8(1):13-8 (https://doi.org/10.1016/j.bjpt.2019.01.010), Symptom to Diagnosis: An Evidence-Based Guide, (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?bookid=2715§ionid=228237277), (https://medlineplus.gov/lab-tests/differential-diagnosis/), Visitation, mask requirements and COVID-19 information, Chronic obstructive pulmonary disease (COPD). What Stands in the Way of Bedside Teaching? [ 21, 22, 23] Occasionally, plaquelike lesions of lichen planus and lupus erythematosus may resemble areas of frictional keratosis. Carotid dissection may also present as an isolated hypoglossal nerve palsy. Can you diagnose the cause of the patients lymphedema? The plaque-like form of oral lichen planus is easily confused with leukoplakia.18 For symptomatic patients, administering topical or systemic steroids remains the most common therapy. Transverse furrows across the tongue may be from a benign condition called scrotal tongue. Campbell WW. Typical signs of hypothyroidism such as fatigue, weight gain, hypothermia, dry skin, and myxedema with facial fullness, as in our patient, are well known but are neither sensitive nor specific, and the clinical picture can vary substantially with a slow long-term progression often leading to non- or misdiagnosis [ 2 ]. It should not deviate to either side. 2014;23:e405-e406. J Tradit Complement Med. Bookshelf Contralateral Tongue Deviation Due to Paramedian Pontine Infarction: A Brief Review of Cortico-Hypoglossal Projections. Attention Dental Professionals! The tongue exam can reflect a number of underlying diagnoses such as infections, nutritional deficiencies, malignancy and even neurological dysfunction. The movies are licensed under a Creative Commons Attribution-NonCommerical-ShareAlike 2.5 License. In newborns there may be an apparent microglossia resulting from a congenitally short lingual frenulum (ankyloglossia) commonly called a tongue tie. This presents with a small, stiff tongue. [QxMD MEDLINE Link]. Common tongue conditions in primary care. Should fit comfortably in mouth, tip against lower incisors. Most patients with hairy tongue remain asymptomatic,5,13 although complaints of oral malodor, nausea or altered taste have been reported. 3. Food is positioned on the body of the tongue and raised upward to the palate to break up the food prior to swallowing. If medication use is implicated, hairy tongue will resolve once the offending agent is eliminated.12 Hairy tongue should not be confused with oral hairy leukoplakia, which is caused by the Epstein-Barr virus.13 Oral hairy leukoplakia differs in its anatomic location and its association with immunosuppression. The https:// ensures that you are connecting to the 2. Save my name, email, and website in this browser for the next time I comment. Tongue deviation towards lesion; Inferior ASA. Nutritional deficiencies include iron, folate and vitamin B12 deficiency. Erythroplakia of mouth or tongue. eCollection 2022 Sep. Smaoui S, Peladeau-Pigeon M, Mancopes R, Sutton D, Richardson D, Steele CM. doi: 10.12659/AJCR.936511. There should be no hairs, furrows, or ulceration. This site needs JavaScript to work properly. These are your clinical examination findings: weakness of the left upper and lower limbs, with sparing of the face. Next is its size. Dr Nigel Stollery explains the differences in characteristic features of diseases of the tongue. The aspects of the tongue considered in diagnosis include: Tongue spirit or vitality Body color Body shape Tongue coating Tongue moisture In addition, various features are also considered, including absence or presence of and the characteristics of movement, bristles, cracks, and teethmarks. Cerebrovasc Dis 2000;10:462465. The differential diagnosis will direct your healthcare provider to offer tests to rule out conditions and lead them to find the cause of your symptoms. Eye deviation; Head and neck jerky movements; No tonic contraction of the muscles between the spasms; Dyskinesia of the tongue and lips; Dyskinesia of the limbs; Dyskinesia of the neck; It is a clinical diagnosis depending on 2009;29(1):4552. 1999 Nov. 41(5 Pt 1):746-8. You are being redirected to Abstract. A structure for accurate diagnosis is proposed beginning with a very careful history. There has been debate as to whether oral lichen planus is likely to transform into oral cancer.20 The risk is thought to vary between 0.5% and 5% over a period of 1 to 20 years.18, Diagnosis of oral lichen planus should be made based on clinical and histologic findings, as many other conditions can clinically mimic the condition such as graft-versus-host disease, leukoplakia and squamous cell carcinoma. Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: an enigmatic oral lesion. 29% of stroke patients and 5% of controls had tongue deviation (p < 0. Testing strength consists of the patient forcing the tongue to the side against the patients cheek, while the examiner tries to dislodge the tongue using his/her finger[2]. Int J Environ Res Public Health. Progressive nuclear lesions, such as motor neuron disease, often cause fasciculations in addition to weakness. A . Profiles of Swallowing Impairment in a Cohort of Patients With Reduced Tongue Strength Within 3 Months of Cerebral Ischemic Stroke. Your patient gets this rash, whats the diagnosis? 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.cmpa-acpm.ca/en/education-events/good-practices/physician-patient/clinical-decision-making), (https://www.cdc.gov/urdo/differential.html). Am J Case Rep. 2022 Jun 8;23:e936511. Asthma Symptoms of asthma include shortness of breath, wheezing, pain or a tight feeling in your chest and coughing. Following an evaluation, your healthcare provider might order laboratory or imaging tests to confirm diagnostic theories that will pinpoint which condition is most accurate. when do starlings start talking. The tongue is also used to form words for speaking. The history should include information regarding onset, duration and symptoms, as well as history of alcohol and tobacco use. 2010 Feb 17. [Necrotizing vasculitis of the tongue. The tongue is a complex organ composed of muscles, minor salivary glands, papillae, sensory and motor nerve fibers, blood vessels, adipose tissues, etc., This wide variety of tissues poses. Technique of the Tongue Exam On physical examination, there are several characteristics of the tongue that should be noted: Color Pink-red on dorsal and ventral surfaces. Muscle Nerve. 2009 Oct 15. -, Epilepsia. [QxMD MEDLINE Link]. Diagnostic evaluation may include measuring the degree of head tilt and face turn. dizziness. The formal continuing education programs of this program provider are accepted by the AGD for Fellowship/Mastership and membership maintenance credit. 2022 Apr 7;12(5):505-510. doi: 10.1016/j.jtcme.2022.04.001. Hypoglossal nerves can be damaged unilaterally by a multitude of causes especially, tumors, infection, or trauma. Your email address will not be published. 1996. Other diseases of tongue. Median rhomboid glossitis: a clinical and microbiological study. The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. Scenario 1. Disclaimer. The prevalence of tongue lesions in 5150 Turkish dental outpatients. At this stage in the diagnostic process, your healthcare provider will offer tests as a process of elimination to narrow down your specific diagnosis. 2014 Jul;52(6):572-4. doi: 10.1016/j.bjoms.2014.04.005. . A differential diagnosis of a headache includes: Symptoms of hypertension include chest pain, headaches, dizziness, shortness of breath and feeling tired. Gross anatomy and development of the peripheral nervous system. However, bilateral lesions can cause profound difficulty with speech and swallowing as the patient cannot protrude the tongue for these necessary functions. Odynophagia concurrent with this suggests that the esophagus is also involved. A differential diagnosis is a list of possible conditions that share the same symptoms that you described to your healthcare provider. A, Fissured tongue. Special attention is given when the tongue is weak, atrophied, moving abnormally, or impaired. [1] Normal tongue [ edit] Multiple cranial neuropathies are commonly caused by tumors, trauma, ischemia, or infections.While diagnosis can usually be made based on clinical features, further investigation is often warranted to determine the specific etiology. Blue Nevi. The lateral borders and tip of the tongue remain uninvolved.5, The etiology for hairy tongue is not well understood. Your healthcare provider will try to learn as much about your symptoms as they can to make a diagnosis. Supranuclear lesions cause weakness but no atrophy, and the weakness is rarely severe. A black hairy tongue in the setting of chronic administration of penicillins is often fungal overgrowth, particularly ofaspergillus. The Hypoglossal nerve is the 12th cranial nerves that originate from the medulla obligate of the brain stem. Several distinctive features point towards a functional movement disorder of the mouth, tongue, or palate. This is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by PICA and its branches 1-3 . [QxMD MEDLINE Link]. Differential Diagnoses. Since the genioglossusthe principal tongue protractorhas mainly crossed supranuclear innervation, the tongue protrudes toward the side opposite a supranuclear lesion. Lingual haemangiosarcoma was diagnosed on histopathological examination of multiple biopsy samples, with confirmation of the vascular endothelial origin of tumour cells by positive immunolabelling for factor VIII-related antigen. It is generally believed that the supranuclear innervation of the hypoglossal nucleus is bilateral and symmetrical. The clinical appearance of geographic tongue can range from minimally evident to very prominent. 81(5):627-34. The condition has periods of flare-ups and remission.20 Extraorally, oral lichen planus can affect the skin, skin appendages and other sites, such as genital, ocular, nasal, laryngeal, gastric and anal mucosa. Tongue weakness may result from a supranuclear, nuclear, or infranuclear lesions. Familiarity with common characteristics of oral lesions in regard to color, shape, size, location and morphology assists practitioners in making an accurate diagnosis. tongue weakness Differential Diagnosis Lambert-Eaton Syndrome Botulism Intracranial mass Drug-induced myasthenia gravis Thyroid disorders Stroke Congenital [emdocs.net] Oral Nevi. It is one step that your healthcare provider will take before making a final diagnosis. Epub 2018 Nov 3. In hemiparesis due to a carotid dissection, the tongue may deviate to the side opposite the hemiparesis because the dissection injures the hypoglossal nerve as it curves around the carotid sheath. The hyperacute clinical diagnosis of stroke remains a major challenge, as 1 in 4 suspected cases turns out to be a stroke mimic. Unauthorized use of these marks is strictly prohibited. Cranial Nerve 4. Other causes of RAU include drug reactions, Marshall Syndrome, and MAGIC (Mouth and Genital ulcers with Inflamed Cartilage) syndrome. Rough dorsal surface owing to papillae, which have three types. -, Forensic Sci Med Pathol. Available at http://library.med.utah.edu/neurologicexam/html/gait_abnormal.html#13. Share cases and questions with Physicians on Medscape consult. Video describes about the tongue deviation in upper motor neurone vs lower motor neurone hypoglossal palsy. Differential Diagnosis & Primary Care Practicum (NR-511) Nursing Care Of The Child (NUR 2310C) English 122 (ENG-122-H6727) . Nelson BL, Thompson L. Median rhomboid glossitis. Cranial nerve palsy is characterized by a decreased or complete loss of function of one or more cranial nerves. Aphthous ulcers, or aphthous stomatitis, are a painful form of ulcer that is frequently encountered. 8600 Rockville Pike (1,2) Whether this is toward or away from the side of the lesion depends on the specifics of the lesion. loss of vibration and proprioception in the left upper and lower limbs. An official website of the United States government. Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental AssociationDisclosure: Nothing to disclose. Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature. Blockage in the liver, gall bladder or bile ducts. Stein SL, Mancini AJ. 300 patients with acute unilateral ischaemic motor strokes (excluding those in the lower brainstem) and an equal number of normal controls were studied for the presence of tongue deviation in a standardised manner. By forming a differential diagnosis, additional testing is necessary to lead your healthcare provider to the correct diagnosis instead of treating symptoms without understanding the cause. J Cutan Pathol. Jean Paul Ortonne, MD is a member of the following medical societies: American Academy of DermatologyDisclosure: Nothing to disclose. A supranuclear palsy will cause motor dysfunction contralateral to the side of the lesion without atrophy or fasciculations. Please enable it to take advantage of the complete set of features! and transmitted securely. A white tongue can occur due to a variety of medical conditions: 1. Health/Lippincott Williams & Wilkins, 2013. The ulcers themselves may become infected, requiring treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. The most commonly used terms, however, are geographic tongue or benign migratory glossitis.6, The reported prevalence of geographic tongue ranges from 0.28% to 14.4%,6 although most surveys note the range between 1.0% and 2.5%.6,7 Shulmans and Carpenters population-based, case-control study, which looked at data from 16,833 American adults in NHANES 19881994, found that geographic tongue was more prevalent among whites and blacks compared to Mexican-Americans.4 There is debate about which age group is most frequently affected. Cullins MJ, Lenell C, Ciucci MR, Connor NP. 2008 Jun;49(6):962-7 Exploring the pivotal variables of tongue diagnosis between patients with acute ischemic stroke and health participants. Isolated hypoglossal nerve palsy is rare, but occasionally it appears as the initial or solitary sign of an intracranial or extracranial space-occupying lesion, a head and neck injury, or a vascular abnormality of the internal carotid artery. Usually, one side of the tongue is affected, and when the person sticks out his or her tongue, it deviates or points toward the side that is damaged. Bronchitis. In tongue diagnosis how and if the tongue moves also has meaning, as also its shape , colour , coating and how moist or dry it is.
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