Clinical characteristics and course of oral somatic delusions: a retrospective chart review of 606 cases in 5 years

Umezaki, Yojiro; Miura, Akiko; Shinohara, Yukiko; Mikuzuki, Lou; Sugawara, Shiori; Kawasaki, K.; Tu, Trang Thi Huyen; Watanabe, Takeshi; Suga, Takayuki; Watanabe, Motoko; Takenoshita, Miho; Yoshikawa, Tatsuya; Uezato, Akihito; Nishikawa, Toru; Hoshiko, Ken; Naito, Toru; Motomura, Haruhiko; Toyofuku, Akira

doi:10.2147/ndt.s167527

Cited by 18 publications

(42 citation statements)

References 18 publications

(23 reference statements)

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“…The patients without NVC of trigeminal nerves was found in 51.9% patients and predominantly female. The rate (85.2%) coincides with the previous studies of OC (73.8%) [5] and other psychosomatic dental symptoms [24][25] [26]. Moreover, the patients without NVC showed signi cantly more complexed oral symptoms with higher severity and functional impairment in working and social activity which decline the quality of life though no signi cance were observed in psychological questioners compared to the patient with NVC.…”

Section: Discussionsupporting

confidence: 86%

“…Previously, the existence of the subtypes of OC have been suggested based on the etiology [3] and clinical mental manifestation [4]. Moreover, since the comorbidity of psychotic disorders such as schizophrenia and bipolar was found only 6% in the OC patients, the authors conclude the oral cenesthopathic sensation might not be merely a partial symptom of psychotic disorders that present delusional symptoms [5]. These results suggest that the pathophysiology of OC differ from psychotic disorders.…”

Section: Introductionmentioning

confidence: 92%

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The difference in clinical characteristics in the patients with unilateral oral cenesthopathy with and without the neurovascular compression of trigeminal nerve: A clinical chart review

Watanabe¹,

Watanabe²,

Suga³

et al. 2020

Preprint

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Background Oral cenesthopathy (OC) is characterized by unusual sensation in the oral cavity without corresponding medical and dental evidence. Their complaints are vary and some patients show sever symptoms which decline their quality of life. The neurovascular compression (NVC) of trigeminal nerves is known as one of the factors to indicate abnormal sensation in facial area including oral cavity. The aim of the present study was to investigate the pathophysiology of OC by comparing the clinical characteristics of unilateral OC patients with and without trigeminal nerve NVC. Methods This is a retrospective study reviewing medical records of patients diagnosed with unilateral OC seen between April 2016 and February 2019. Magnetic resonance images (MRI) were performed to assess the presence of NVC. Results Among 321 patients who were diagnosed with OC, 87 patients showed unilateral OC. finally, 52 patients who were performed MRI were involved in the present investigation. In 48.1% subjects (25/52), NVC of trigeminal nerves was observed. In the patients without NVC, 85.2% (23/27) were female with significant difference (p = 0.010) compared to the patients with NVC (48.0%, 12/25). There was no significant difference in age, the presence of psychiatric history and psychosomatic dental comorbidity, and the scores of psychological questionnaires. However, in the patients without NVC, significantly higher scores were observed in the symptom severity and the functional impairment as follow; movement (p = 0.042), pain (p = 0.040), work (p = 0.013) and social activities (p = 0.015), compared to the group with NVC. Conclusion These results suggest that unilateral OC has two subtypes based on predominant involvement of peripheral or central nervous system (CNS). The unilateral OC with NVC may involve predominantly peripheral nervous system. Furthermore, the unilateral OC without trigeminal nerve NVC which showed severe functional impairment may be reflected predominant CNS involvement.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 92%

The difference in clinical characteristics in the patients with unilateral oral cenesthopathy with and without the neurovascular compression of trigeminal nerve: A clinical chart review

Watanabe¹,

Watanabe²,

Suga³

et al. 2020

Preprint

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“…It is probably true that some central sensitization might be related to BMS, as are other functional somatic syndromes [28, 29], however, recent evidence shows its limitations, especially for elderly patients [30, 31]. In addition, the pathophysiology should be considered not only as a pure painful sensation but also as oral discomfort that includes dysgeusia and subjective dry mouth [32, 33], which seems to be more common in the elderly.…”

Section: Overview Of Burning Mouth Syndromementioning

confidence: 99%

Current management strategies for the pain of elderly patients with burning mouth syndrome: a critical review

Takenoshita

Matsuoka

et al. 2019

BioPsychoSocial Med

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Burning Mouth Syndrome (BMS), a chronic intraoral burning sensation or dysesthesia without clinically evident causes, is one of the most common medically unexplained oral symptoms/syndromes. Even though the clinical features of BMS have been astonishingly common and consistent throughout the world for hundreds of years, BMS remains an enigma and has evolved to more intractable condition. In fact, there is a large and growing number of elderly BMS patients for whom the disease is accompanied by systemic diseases, in addition to aging physical change, which makes the diagnosis and treatment of BMS more difficult. Because the biggest barrier preventing us from finding the core pathophysiology and best therapy for BMS seems to be its heterogeneity, this syndrome remains challenging for clinicians. In this review, we discuss currently hopeful management strategies, including central neuromodulators (Tricyclic Antidepressants - TCAs, Serotonin, and Norepinephrine Reuptake Inhibitors - SNRIs, Selective Serotonin Reuptake Inhibitors - SSRIs, Clonazepam) and solutions for applying non-pharmacology approaches. Moreover, we also emphasize the important role of patient education and anxiety management to improve the patients’ quality of life. A combination of optimized medication with a short-term supportive psychotherapeutic approach might be a useful solution.

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“…It is mentioned among the 4 most common forms of ‘ Monosymptomatic Hypochondriac Psychosis ’, along with Olfactory Reference Syndrome , Dysmorphophobia and Delusional Parasitosis 8 . Patients with OC may sometimes have accompanying BMS symptoms 9 . Similarly, in some rare cases, patients diagnosed with BMS may complain of bizarre bodily sensations consistent with OC, in addition to burning and pain 7 …”

Section: Introductionmentioning

confidence: 99%

Oral cenesthopathy superimposed on burning mouth syndrome treated with aripiprazole: A case report with a phenomenological overview

Karakuş

Bulut

2021

Gerodontology

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Background Burning mouth syndrome (BMS) is an idiopathic condition that presents with chronic pain and/or burning sensations in the oral structures. The syndrome mostly affects elderly women with hormonal changes and/or with a diagnosis of comorbid psychiatric disorder. In some rare conditions, the clinical appearance of BMS may also overlap with oral cenestopathy (OC), which is defined in the literature as a special form of delusional disorder of somatic type. Patients with OC may complain about abnormal experiences such as melting, feeling of stickiness, as well as extremely strange feelings of wires, metal coils, etc being present in their mouths. Case Presentation We present an elderly woman whose ongoing symptoms of BMS (burning in the mouth and tongue, taste alterations etc) were, over time, superimposed by cenesthopatic delusions that her gums had melted, and her palate had totally dissolved. We believe that the case is clinically striking and demonstrative for the understanding of complex nosology of BMS and OC, given that (a) the patient exhibited a relatively rare example of overlapping BMS and OS symptoms, which both are not sufficiently recognised by clinicians, (b) OC symptoms have disappeared with low‐dose aripiprazole and psychoeducation‐based cognitive therapy, which resulted in significant improvement in the patient's quality of life. Conclusion Clinicians are required to be aware of BMS and OC, two syndromes with multifactorial aetiology and highly heterogeneous presentation, in order to determine the most appropriate treatment options from a multidisciplinary perspective, as well as to avoid unnecessary medical interventions.

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Clinical characteristics and course of oral somatic delusions: a retrospective chart review of 606 cases in 5 years

Cited by 18 publications

References 18 publications

The difference in clinical characteristics in the patients with unilateral oral cenesthopathy with and without the neurovascular compression of trigeminal nerve: A clinical chart review

The difference in clinical characteristics in the patients with unilateral oral cenesthopathy with and without the neurovascular compression of trigeminal nerve: A clinical chart review

Current management strategies for the pain of elderly patients with burning mouth syndrome: a critical review

Oral cenesthopathy superimposed on burning mouth syndrome treated with aripiprazole: A case report with a phenomenological overview

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