Topiramate Effective in the Treatment of Intractable Glossodynia

Objective: To report effective treatment with topiramate in 2 cases of glossodynia (burning tongue and mouth syndrome). Case Summaries: Two women, 52 and 53 years old, suffered from intractable unilateral burning mouth syndrome. In both cases, the activities of daily living were severely restricted. Previous treatment with diverse medications had failed. Administration of topiramate 200-350 mg/day stopped the attacks completely in one patient and reduced the frequency by 50-60% in the second. Discussion: Glossodynia may present as unilateral intractable pain syndrome with characteristics of neuralgic pain. It is defined as a burning pain in the tongue and mucous membranes of the mouth. There is some research on possible effective medications for treatment, but few data on the beneficial effects of this therapy have been reported. Topiramate has been previously shown to have an antineuralgic effect in trigeminal neuralgia. In the cases of intractable glossodynia presented here, this medication led to significant improvement in the symptoms of this uncommon neuralgic pain. Conclusions: Topiramate has a beneficial effect in intractable burning mouth and tongue syndrome. Taking these positive results into consideration, the practitioner can give hope to disabled patients for returning to acceptable activities of daily living.