Zungenbrennen

Zusammenfassung

Unter Zungenbrennen oder Mundbrennen versteht man eine Dysästhesie der Zungen- und Mundschleimhaut ohne erkennbare Veränderung der oralen Mukosa. Dem sekundären Zungenbrennen liegt eine Allgemeinerkrankung, z. B. Diabetes mellitus, zugrunde, während bei primärem Zungenbrennen keine Ursache feststellbar ist. Die Prävalenz liegt bei 1 - 2 %, Frauen nach der Menopause sind besonders häufig betroffen. Primäres Zungenbrennen ist häufig mit Xerostomie und/oder Dysgeusie vergesellschaftet. Man geht derzeit davon aus, dass es sich um eine fokale gemischt peripher/zentrale Neuropathie handelt. Therapie der Wahl bei primärem Zungenbrennen ist α-Liponsäure. Bei Nichtansprechen stellen Antikonvulsiva mit Wirkung auf neuronale Kalziumkanäle (Gabapentin, Pregabalin) eine sinnvolle Therapieoption dar. Es liegen außerdem Untersuchungen zu lokaler Anwendung des Benzodiazepins Clonazepam vor. Nach derzeitigem Kenntnisstand sind Antidepressiva wenig wirksam.

Abstract

Burning mouth syndrome (BMS) is characterized by oral dysesthesia, xerostomia and dysgeusia without visible alterations of oral mucosa. While secondary BMS results from an underlying general condition such as diabetes or iron deficiency, no causal disorder can be identified in primary BMS. The estimated prevalence is 1 - 2 %, postmenopausal women are substantially more frequently affected than men. Current etiologic concepts assume a focal peripheral and central neuropathy. Only few controlled drug trials have yet been conducted. Thioctic acid appears the medical treatment of choice due to its comparatively good evidence for efficacy and low incidence of adverse reaction. Gabapentin and pregabalin are modern GABA-analogue anticonvulsants, which are also efficient in the treatment of peripheral neuropathies. Also conceptually appropriate for BMS treatment, current evidence for efficacy in BMS is insufficient. In two trials, local oral treatment with clonazepam has been beneficial in BMS. The efficacy of antidepressants is equivocal.

Schlüsselwörter

Zungenbrennen - Glossodynie - Mundbrennen - Neuropathie - Gabapentin - α-Liponsäure

Key words

burning mouth syndrome - glossodynia - Peripheral Nervous System Diseases - gabapentin - thioctic acid

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