TITLE:
Successful Treatment of a Case of First Bite Syndrome without Any Cause
AUTHORS:
Seong Ho Chang, Byung Sun Jun, Jong Ouck Choi, Jung Jun Kim, Young Jang
KEYWORDS:
First Bite Syndrome, Mandibular Nerve Block, Oral Medication, Trigger Point Injection
JOURNAL NAME:
World Journal of Neuroscience,
Vol.5 No.5,
November
3,
2015
ABSTRACT: Background: For the first
bite syndrome (FBS), various causes were suggested such as parapharyngeal space
surgery, resection of styloid process, carotid endarterectomy, parotid gland
tumor, submandibular gland tumor, and upper cervical surgery. Actually, the
real cause of FBS is still not clear. Also, suggested methods of treatment for
the FBS are botulinum toxin injection, laser tympanic plexus ablation,
pharmacologic approach, and no treatment. The results of those treatments were
not satisfactory. Aim: The authors tried to find out the adequate method of
treatment for the FBS and also tried to figure out pathologic cause of the FBS
through observation of the patient response to the treatment. Case
Presentation: A 38-year-old male was presented at head and neck surgery clinic
with a sharp pain on the left parotid area especially at the first bite of
eating food for two days. There was no cause. The patient was given trigger
point injections on his left sternocleidomastoid, masseter, and temporal
muscles with left mandibular nerve block five times 3 - 4 days apart. Also
small amount of oral anticonvulsants were added for four weeks. Before
finishing taking oral medication, the pain was gone completely. Conclusion: The
authors experienced a case of FBS with no detectable cause, and treated
successfully with the methods of trigger point injection, mandibular nerve
block, and oral antiepileptic medication.