Neck-tongue syndrome

Multimodal Management of Coexisting Atlantoaxial Subluxation and Spinal Stenosis in an Older Adult: A Case Report and Literature Review

This case report investigates the diagnostic and therapeutic challenges caused by the coexistence of atlantoaxial subluxation and spinal stenosis in a 70-year-old male patient with chronic progressive numbness in both hands. A detailed assessment showed that the patient's symptoms were primarily caused by spinal stenosis, not atlantoaxial subluxation. Considering the patient's age and preference for nonsurgical treatment, a conservative chiropractic care plan was implemented, significantly improving his symptoms and quality of life. This case highlights the potential benefit of conservative chiropractic care in managing such complex cases, emphasizes the need for meticulous diagnosis, and requires further research to validate these findings and develop comprehensive management guidelines.

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

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.