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Dr Basu
Dr Basu, Board Certified MD
Category: Neurology
Satisfied Customers: 29245
Experience:  15 years' clinical experience
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I am on this page as I am trying to understand what I am

Customer Question

I am on this page as I am trying to understand what I am dealing with. For past 3 weeks, paresthesia in lower lip- tingling esp when eating or speaking. Not pain though. Lips and tongue feel tingly and "burnt"- as if I've eaten a jalapeno. Had MRI and MRA- normal. Vit B bloodwork low normal. No dental work. 2 years ago mild case of shingles, but affected jaw area. This time- this constant tingling and spasming of lower lip. No telltale shingles or herpes lesions. No stabbling pain or numbness. Really just in despair at this point. Starting acupuncture, but not too hopeful. It doesn't fit TGN 1 and not quite ? for TGN 2. Burning mouth syndrome? Have not had dental exam yet-- but no teeth hurting. Help?
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr Basu replied 2 years ago.

Hi there,

I understand your frustration.

No this is not typical trigeminal neuragia.

Since no oral lesion, herpes or shingles unlikely.

You do have low normal b12 which can be a cause.

Also deficiency or iron, zinc, folate, vitamin b6 should be ruled out.

Otherwise, this is likely burning mouth syndrome.

You meet the diagnostic criteria.

Can be caused by the small sensory fiber neuropathy.

Treatment can be achieved by clonazepam, or gabapentin or pregabalin.

Best wishes,
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