Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Japan.
Psychogeriatrics. 2013 Jun;13(2):99-102. doi: 10.1111/j.1479-8301.2012.00430.x.
Glossodynia is chronic pain localized around the tongue, with no perceivable organic abnormalities. In the fields of oral and maxillofacial surgery, it is categorized as an oral psychosomatic disease. In contrast, psychiatric nosology classifies glossodynia as a pain disorder among somatoform disorders, per the DSM-IV. The patient was a 71-year-old woman who developed symptoms of glossodynia, specifically a sore tongue. In the decade before she presented to us, she had had bizarre symptoms of oral cenesthopathy such as the sensation that her teeth had become 'limp and floppy' and that she needles in her mouth. Treatment was attempted using several psychotropic drugs, but no satisfactory response was noted. Because the patient was referred to our outpatient clinic, we tried psychotropic therapy again. Additionally, valproic acid, tandospirone and sertraline were administered (in this order), but the patient still showed no response. However, when sertraline was changed to milnacipran, all symptoms disappeared in a short period. We suggest that a small dose of milnacipran can be effective for controlling oral cenesthopathy as well as glossodynia.
舌痛症是一种以舌部为主要发病部位的慢性疼痛性疾病，无明显的器质性异常。在口腔颌面外科领域，它被归类为口腔心身疾病。相比之下，根据 DSM-IV，精神病学分类将舌痛症归类为躯体形式障碍中的疼痛障碍。该患者为 71 岁女性，出现舌痛症症状，具体表现为舌痛。在她就诊前的十年里，她曾出现过口腔感觉异常的奇异症状，如牙齿“松软”和“无力”以及口中有针感。曾尝试使用几种精神药物进行治疗，但未观察到满意的效果。由于患者被转介到我们的门诊，我们再次尝试进行精神药物治疗。此外，给予了丙戊酸钠、坦度螺酮和舍曲林（按此顺序），但患者仍无反应。然而，当舍曲林换用米那普仑时，所有症状在短时间内消失。我们建议小剂量米那普仑可有效控制口腔感觉异常和舌痛症。
