Use of topiramate for glossodynia.
BACKGROUND
Glossodynia is a multifunctional disorder characterized by painful sensations in the mouth and throat and especially on the tongue. It is commonly cured by long-term therapy with systemic regimens of anxiolytics, antidepressants, and anticonvulsants.


METHODS
We report here the case of a 65-year-old woman with a 4-month history of glossodynia. Clinical and laboratory evaluations performed the diagnosis of idiopathic glossodynia, and several treatments with carbamazepine and then with gabapentin induced the development of serious adverse reaction. Only treatment with topiramate has been able to induce a complete improvement of symptoms.


CONCLUSIONS
The pathogenesis of idiopathic glossodynia remains unclear, since it recently has been suggested as a possible neuropathic basis of burning mouth syndrome, demonstrating an altered excitability in the trigeminal nociceptive pathway at peripheral and/or central nervous system level. The various mechanisms of topiramate, which act at different neural transmission levels, blocking sodium and calcium channels, enhancing GABA concentration, and decreasing glutamate function at postsynaptic site, may explain the effects of topiramate in our patient.


CONCLUSIONS
Therefore, we suggest that topiramate could represent a useful therapeutic option in the treatment of glossodynia.
Siniscalchi
Antonio
A
Department of Neuroscience, Neurology Division, Annunziata Hospital, Cosenza, Italy.
Gallelli
Luca
L
Marigliano
Norma Maria
NM
Orlando
Paola
P
De Sarro
Giovambattista
G
D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005926:Glossalgia / Q000188:drug therapy*; D006801:Humans; D010147:Pain Measurement; D000077236:Topiramate
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose