Abstract
Japan’s aged population is rapidly increasing and the country has become a super-aged society. The average age of our department’s first-visit patients is 64.2 years, and the number of patients with oral psychosomatic disorders is also increasing. The number of patients with dementia is increasing along with the aging of the population, and it has been reported that oral dysesthesia and burning mouth syndrome may precede dementia with Lewy bodies. Although it has been pointed out that regular monitoring of cognitive function is important in clinical practice of oral psychosomatic disorders, the treatment of patients with burning mouth syndrome with dementia has not yet been established.
A 70-year-old housewife came to our hospital with a chief complaint of tingling pain at the tip of the tongue. Based on the clinical findings and the characteristics of her complaints, we diagnosed her with burning mouth syndrome, but because we suspected cognitive decline, we decided not to prescribe antidepressants at the initial visit and to monitor her progress with symptomatic treatment. After careful consultation, we referred the patient to a neurologist at the request of the patient and her husband, and she was diagnosed with Alzheimer’s disease. The neurologist prescribed donepezil. We prescribed a small dose of aripiprazole for burning mouth syndrome, with the neurologist’s recommendation. After the prescription, there were no side effects or further deterioration of cognitive function, and the pain gradually improved. After discontinuation of the prescription, there was no recurrence of pain.
Treatment with aripiprazole was successful in this patient with burning mouth syndrome comorbid with Alzheimer’s disease. Appropriate communication with the patient’s family and collaboration with a neurologist are important in the treatment. We believe that it is necessary to continue to accumulate detailed case reports and consider appropriate measures in the future.
