Galeazzi Leon, Holzman Judith, Porporatti André, Rochefort Juliette
Oral Surgery, Pitie Salpetriere Hospital, AP-HP (Assistance Publique - Hôpitaux de Paris) Paris Cité University, Paris, FRA.
Dentistry, Pitie Salpetriere Hospital, AP-HP (Assistance Publique - Hôpitaux de Paris) Paris Cité University, Paris, FRA.
Cureus. 2024 Jul 9;16(7):e64153. doi: 10.7759/cureus.64153. eCollection 2024 Jul.
Dental surgeons often play a pivotal role in the initial detection of lingual fasciculations (LFs). These involuntary micro-movements of the tongue can serve as early clinical indicators of neurodegenerative diseases, with amyotrophic lateral sclerosis (ALS) being the most concerning. Therefore, it is imperative to educate dental surgeons on identifying LF and understanding the potential underlying pathologies.
This study aimed to pinpoint the pathologies in which LFs could emerge as an early clinical marker. Our review focused on articles delineating patient populations exhibiting LF within broader pathological contexts, encompassing neurological and other conditions, with the aim of elucidating their etiologies.
We conducted a comprehensive literature review across four databases (PubMed, Embase, Web of Science, and Scopus). Two authors independently extracted data, with consultation from a third author when necessary. Eligible articles included those describing patients with LFs, detailing the methods of detection, diagnosis, and associated pathologies.
Our review identified 22 articles encompassing 153 patients with LF, with an average age of 45.8 years and a female prevalence of 43%. Electromyography and ultrasound emerged as the predominant detection methods. ALS constituted the primary diagnosis in the majority of cases (91%). Additionally, other conditions diagnosed included Machado-Joseph disease (0.046%), familial transthyretin amyloid neuropathy (0.013%), Brown-Vialetto-Van-Laere syndrome (0.006%), chronic inflammatory demyelinating polyneuropathy (0.006%), bulbospinal amyotrophy or Kennedy's disease (0.006%), and osmotic demyelination syndrome (0.006%). LF secondary to organophosphate poisoning was also documented. Symptoms associated with LF encompassed taste alterations, dysphagia, difficulty swallowing, and slurred speech.
While primarily indicative of ALS, LFs may also signal diverse underlying pathologies. Healthcare practitioners should be vigilant in their detection and expedite patient referrals to facilitate early integration into care protocols.
牙科医生在舌肌束颤（LFs）的早期检测中往往起着关键作用。这些舌头的非自主微运动可作为神经退行性疾病的早期临床指标，其中肌萎缩侧索硬化症（ALS）最为令人担忧。因此，对牙科医生进行识别LFs以及了解潜在相关病理情况的教育至关重要。
本研究旨在确定LFs可能作为早期临床标志物出现的病理情况。我们的综述聚焦于描述在更广泛病理背景下出现LFs的患者群体的文章，包括神经及其他疾病，以阐明其病因。
我们在四个数据库（PubMed、Embase、Web of Science和Scopus）中进行了全面的文献综述。两位作者独立提取数据，必要时咨询第三位作者。符合条件的文章包括描述有LFs患者的文章，详细说明了检测、诊断方法及相关病理情况。
我们的综述纳入了22篇文章，涉及153例LFs患者，平均年龄45.8岁，女性患病率为43%。肌电图和超声是主要的检测方法。大多数病例（91%）的主要诊断为ALS。此外，诊断出的其他疾病包括马查多 - 约瑟夫病（0.046%）、家族性转甲状腺素蛋白淀粉样变性神经病（0.013%）、布朗 - 维阿莱托 - 范莱尔综合征（0.006%）、慢性炎症性脱髓鞘性多发性神经病（0.006%）、延髓脊髓性肌萎缩或肯尼迪病（0.006%）以及渗透性脱髓鞘综合征（0.006%）。还记录了有机磷中毒继发的LFs。与LFs相关的症状包括味觉改变、吞咽困难、吞咽障碍和言语含糊不清。
虽然LFs主要提示ALS，但也可能表明多种潜在的病理情况。医疗从业者在检测时应保持警惕，并加快患者转诊，以便尽早纳入护理方案。
