Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome

The Journal of Headache and Pain

Research Article

Dimos D. Mitsikostas¹  Christina I. Deligianni²  Srdjan Ljubisavljevic³ 

[1] Aeginition Hospital, National & Kapodistrian University of Athens, Athens, Greece;Aeginition Hospital, National & Kapodistrian University of Athens, Athens, Greece;Neurology Department, Athens Naval Hospital, Athens, Greece;Clinical Center of Nis, Clinic for Neurology, University of Nis, Nis, Serbia;

关键词: Burning mouth syndrome;    Clinical picture;    Treatment;    Venlafaxine;    Clonazepam;    Outcome;   

DOI  :  10.1186/s10194-017-0745-y

 received in 2017-02-07, accepted in 2017-03-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundBurning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent intraoral burning without related objective findings and unknown etiology that affects elderly females mostly. There is no satisfactory treatment for BMS. We aimed to observe the long-term efficacy of high velanfaxine doses combined with systemic and topical administered clonazepam in a particular subgroup of BMS patients who do not respond to current clinical management.ResultsEight (66.1 ± 6.2 years old females) out of 14 BMS patients fulfilled the inclusion criteria and were treated with venlafaxine (300 mg/d) and clonazepam (5 mg/d) for 35.4 ± 12.1 (mean ± SD) months. The average duration of the symptoms at baseline was 4.3 ± 1.4 years and the overall mean daily pain intensity score was 8.6 ± 1.3 (VAS); pain was in tongue and within the oral mucosa, accompanying by oral and facial dysesthesia. In five patients tasting was abnormal. All patients had positive history of concomitant primary headache. The average score of Hamilton Rating scale for Anxiety and Depression was 21 ± 4.2, and 26.1 ± 2.9, respectively. Previous ineffective treatments include anticonvulsants and anti-depressants. All patients responded (more than 50% decrease in VAS) after three months treatment (mean VAS 3.2 ± 2.2) with no remarkable adverse events.ConclusionBMS deserves bottomless psychiatric evaluation and management when current available treatments fail. Treatment with venlafaxine combined with topical and systemic clonazepam may be effective in refractory BMS cases but further investigation in a large-scale controlled study is needed to confirm these results.

【 授权许可】

CC BY   
© The Author(s). 2017