Lingual Nerve Injury

Steven B. Graff-Radford, DDS, Randolph W. Evans, MD

Disclosures

Headache. 2003;43(9) 

In This Article

Examination

Typical workup includes a detailed history, behavioral assessment, and physical examination. Details of the examination have been described by Canavan and Graff-Radford, and will not be reviewed in detail here.[62] Specific sensory testing may be necessary to monitor progress over time, and responses to von Frey tactile sensory stimuli and Minnesota Thermal Disks, as well as responses to heat, are useful but not essential. Two-point discrimination also may help identify recovery over time. There is a significant false-positive and -negative rate with this test. Taste testing may be performed, but it is difficult to obtain accurate responses. Unfortunately, all these tests are subjective, requiring a self-response. Operate factors may therefore change responses. Palpation over the injury site may produce a local sensitivity or an evoked sensation in the tongue. This may be due to the presence of axonal sprouts in the scar tissue or central sensitization and mechanical allodynia. These phenomena can be demonstrated where the damage to the nerve leaves it intact (compression).[13,63] In animal models, spontaneous neural activity and mechanical sensitivity occurred at the same rate despite the type or extent of injury.[64]

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