Tongue Rigidity: Symptoms and Possible Causes

Symptoms of tongue immobility?

Hello Doctor: About six months ago, I started to feel a lack of dexterity in my tongue.
Initially, it was just a sensation of stiffness that did not affect my speech, and the condition fluctuated.
In recent months, whenever I speak a bit faster, I often feel like my tongue is getting tangled or that I am mispronouncing words.
There is often a sound of my tongue hitting the back of my lower teeth, accompanied by a sensation of a foreign body in my nasopharynx and mild headaches.
The symptoms seem to be slowly worsening.
I have already undergone a brain CT and neck ultrasound, both of which were normal.
When I consulted an ENT specialist, they mentioned that I have chronic pharyngitis.
There is no deviation of the tongue or any abnormalities in my limbs.
Could you please advise what possible conditions might be causing this? I work in a profession that requires frequent speaking, and I find it very distressing to be unclear when explaining things.
I would like to know if there are any solutions.

Lin Hsuan-li, 20~29 year old female. Ask Date: 2020/05/19

Dr. Chen Shunsheng reply Rare Disease

Diseases affecting tongue movement include lesions of the muscles, peripheral nerves (cranial nerves), brainstem motor nuclei, and upper motor neuron lesions.
It is important to see a neurologist as soon as possible to determine the location of the lesion and identify the underlying cause.
The most crucial steps involve a thorough medical history, detailed neurological examination, and, if necessary, electrophysiological studies.
MRI or genetic testing may be arranged if needed.

Reply Date: 2020/05/19

More Info

Tongue rigidity and associated symptoms can be quite distressing, especially for individuals whose professions require clear verbal communication. Your experience of tongue stiffness, difficulty in articulation, and the sensation of an object in the nasopharynx, combined with mild headaches, suggests a multifaceted issue that may stem from various underlying causes.

Firstly, it is essential to understand that tongue rigidity can be associated with several neurological and muscular conditions. Some potential causes include:
1. Dystonia: This is a movement disorder characterized by sustained muscle contractions, which can affect the tongue and lead to rigidity. In cases of oromandibular dystonia, the muscles controlling the tongue and jaw may spasm, resulting in difficulty with speech and movement.

2. Parkinson's Disease: Although you mentioned no other motor symptoms, early signs of Parkinson's can include changes in speech and tongue control. Rigidity and bradykinesia (slowness of movement) can manifest in the oral region.

3. Multiple Sclerosis (MS): MS can cause a variety of neurological symptoms, including muscle stiffness and coordination issues. If the nerves controlling the tongue are affected, it could lead to the symptoms you describe.

4. Chronic Inflammatory Conditions: Conditions like chronic pharyngitis or laryngitis can lead to muscle tension in the throat and tongue due to discomfort or pain, which may result in altered speech patterns.

5. Anxiety and Stress: Psychological factors can also contribute to muscle tension, including in the tongue. If you are experiencing stress related to your work, it could exacerbate the feeling of tongue rigidity.

6. Medication Side Effects: If you are taking any medications, particularly those affecting the central nervous system, they could contribute to muscle rigidity or coordination issues.

Given that your CT scan and neck ultrasound were normal, it is reassuring that there are no significant structural abnormalities. However, further evaluation may be warranted. Here are some steps you might consider:
- Neurological Evaluation: A consultation with a neurologist might be beneficial. They can perform a thorough examination and possibly recommend additional tests, such as an MRI, to rule out any neurological conditions.

- Speech Therapy: Engaging with a speech-language pathologist can help you develop strategies to improve your articulation and manage the physical aspects of speaking. They can provide exercises to strengthen your tongue and improve coordination.

- Management of Chronic Inflammation: If chronic pharyngitis is indeed a contributing factor, addressing this condition through appropriate medical treatment may alleviate some of your symptoms.

- Stress Management Techniques: If anxiety is a factor, exploring relaxation techniques, mindfulness, or cognitive-behavioral therapy could be beneficial.

In conclusion, while tongue rigidity can stem from various causes, a comprehensive evaluation by a healthcare professional is essential to determine the underlying issue. Given your profession's demands, addressing these symptoms promptly is crucial for your comfort and effectiveness in communication. Please consider following up with a specialist who can provide tailored advice and treatment options based on your specific situation.

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