title: Neck-Tongue syndrome: A systematic review.
abstract: Objective Neck-Tongue syndrome (NTS) is characterized by brief attacks of neck or occipital pain, or both, brought out by abrupt head turning and accompanied by ipsilateral tongue symptoms. As the disorder is rare, we undertook a systematic review of the literature to identify all reported cases in order to phenotype clinically the disorder and subsequently inform clinical diagnostic criteria. Methods Two electronic databases were searched using the search term "neck tongue syndrome". All English language references were reviewed in full. Cases were abstracted using a standardized abstraction form and the references of the retrieved articles were reviewed by hand to identify additional references and cases. Conference proceedings from recent headache meetings were searched. We also report six new cases from our centers. Results There were 39 primary cases, 56% of which were female. Mean age (SD) at onset was 16 (12) years. Twenty (53%) experienced neck pain, seven (18%) occipital pain, and 11 (29%) both. Pain was most often sharp or stabbing and severe, lasting several seconds to several minutes. Eleven experienced numbness and/or tingling in the neck/occiput following the pain. Thirty-six had an accompanying tongue sensory disturbance and three a motor/posture disturbance; five had both. Thirteen had other headaches, and four a family history of Neck-Tongue syndrome. Conclusions Neck-Tongue syndrome typically has pediatric or adolescent onset, suggesting that ligamentous laxity during growth and development may facilitate transient subluxation of the lateral atlantoaxial joint with sudden head turning. Familial cases suggest a genetic predisposition in some individuals. Neck-Tongue syndrome should be re-instated in the International Classification of Headache Disorders.
authors.affiliation: 1 UCSF Pediatric Headache, University of California, San Francisco, CA, USA.|2 UCSF Child Neurology, University of California, San Francisco, CA, USA.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Gelfand
authors.affiliation: 3 Boston Children's Hospital, Boston, MA, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Johnson
authors.affiliation: 4 University of California, Davis, Department of Neurology, Davis, CA, USA.
authors.forename: Marc Ep
authors.initials: ME
authors.lastname: Lenaerts
authors.affiliation: 2 UCSF Child Neurology, University of California, San Francisco, CA, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Litwin
authors.affiliation: 5 Univsersity of California, Davis, Pain Management Department, Davis, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: De Mesa
authors.affiliation: 6 Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Bogduk
authors.affiliation: 1 UCSF Pediatric Headache, University of California, San Francisco, CA, USA.|7 NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, London, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goadsby
mesh_terms: D000293:Adolescent; D002648:Child; D016208:Databases, Factual; D005260:Female; D020773:Headache Disorders / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000150:complications* / Q000175:diagnosis*; D009778:Occipital Lobe / Q000473:pathology*; D013577:Syndrome; D014060:Tongue Diseases / Q000175:diagnosis*; D055815:Young Adult
keywords: Neck-Tongue syndrome