The neck-tongue syndrome following cervical whiplash injury

Background: Neck-tongue syndrome is a disorder causing unilateral neck pain, accompanied by simultaneous ipsilateral numbness of the tongue. It is explicable by compression of the second cervical root in the atlantoaxial space on sharp rotation of the neck. It may be secondary, idiopathic, familial, more frequent in females, in young people and the pain lasts from a few seconds to a few minutes. Treatment is symptomatic but also prophylactic, benefit is made by physiotherapy treatment. International Headache Society (IHS) places it between “Painful lesions of the cranial nerves and other facial pain”, describing as sudden onset of pain in the occiput or upper neck associated with abnormal sensation in the same side of the tongue. Methods: A 42-year-old female, who a month after reported a whiplash injury, following a car accident, manifested the symptoms of neck-tongue syndrome. The rotational movements of the head to the right side provoked intense pain in the neck and along the right half of the tongue. The pain also appeared spontaneously, duration varied from a few seconds to few minutes, associated with burning, frequency of about two episodes per day. Radiography and cervical spine MRI showed signs of spondylosis. Results: Topiramate combined with non-steroidal anti-inflammatory drugs, improved pain both in the neck and the tongue, reducing the episodes in frequency and intensity. Conclusions: Neck-tongue syndrome is a rare disorder, which manifests with pain in the neck and pain associated with burning of half of the tongue, by unknown etiology. Secondary forms following whiplash injury have not been described, Treatment of these secondary forms concerns use of symptomatic drugs for pain, buth also anticonvulsants as prophylaxis.