A Systematic Review of Case Reports on the Neck-Tongue Syndrome

Abstract

Background and Objectives: Neck-tongue syndrome (NTS) is rare, and characterized by unilateral upper neck or occipital pain and paresthesia in the ipsilateral hemisphere of the tongue due to neck movement. Treatment for NTS is mainly conservative, but the symptoms, causes, and rationale for treatment remain controversial. This study aimed to provide a framework for NTS treatment in clinical practice based on recent treatment directions. Materials and Methods: Case reports published from the past 20 years to August 2021 were searched through MEDLINE, EMBASE, and PEDro databases. Since there is no established management for NTS, the search terms were neck-tongue syndrome and case reports. The Critical Appraisal Checklist for Case Reports was used for the quality assessment of case reports. Through descriptive analysis, NTS symptoms, interventions, and results were reviewed. Results: Among the 16 studies searched, six case reports were selected and analyzed based on eight criteria. Symptoms included neck pain and ipsilateral tongue paralysis when the head was turned. As an intervention, six and four studies showed immediate symptom relief through manual therapy and exercise, respectively. Conclusions: Based on the reviewed evidence, management through physical therapy and chiropractic therapy with conservative methods such as manual therapy and exercise for patients with neck-tongue syndrome is recommended.

Clinical Neurology in Practice

“…145 As first described by James Waldo Lance (1926Lance ( -2019 in 1980, 146 the classic presentation of symptoms is brought on by a brisk, sudden axial rotation of the head: usually, neck and tongue symptoms dissipate in 1 minute. 145 As suggested by Lance and Anthony, the pain is supposed to be due to compression of the second cervical root (C2) in the atlantoaxial space on the sharp rotation of the…”

“…145 Despite no clear treatment recommendations, management through manual therapy and exercise prevailed in a number of cases. 145…”

“…It is an infrequent condition (prevalence: 0.22%) 144 defined as unilateral upper nuchal and/or occipital pain accompanied by transient numbness in the ipsilateral half of the tongue due to head movement 145 . As first described by James Waldo Lance (1926–2019) in 1980, 146 the classic presentation of symptoms is brought on by a brisk, sudden axial rotation of the head: usually, neck and tongue symptoms dissipate in 1 minute 145 . As suggested by Lance and Anthony, the pain is supposed to be due to compression of the second cervical root (C2) in the atlantoaxial space on the sharp rotation of the neck 146 .…”

“…As suggested by Lance and Anthony, the pain is supposed to be due to compression of the second cervical root (C2) in the atlantoaxial space on the sharp rotation of the neck 146 . It was proposed that stimulation of the C2 ventral branch (transmitted through the afferent proprioceptive nerve from the lingual nerve to the C2 nerve root and cervical plexus through anastomosis with the sublingual nerve) causes tongue paresthesia 145 . Despite no clear treatment recommendations, management through manual therapy and exercise prevailed in a number of cases 145 …”

Cranial Neuralgias

“…Treatments lie chiefly in the realm of physical therapy, although other approaches, such as amitriptyline, gabapentin, anti-inflammatory drugs, and peripheral nerve blockade may also be useful 40 . The latter review included only published manuscripts (the former utilized data from many congress abstracts) and confirmed the critical elements of the diagnosis and treatment of neck-tongue syndrome ( case 10-3 ) 41 …”