Author(s)

Seong Ho Chang^1,2*, Byung Sun Jun³, Jong Ouck Choi³, Jung Jun Kim³, Young Jang³

¹Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea.
²Gwanak Otolaryngology, Anesthesia and Pain Clinic, Seoul, Korea.
³Gwanak Otolaryngology, Head and Neck Surgery Clinic, Seoul, Korea.

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.

First Bite Syndrome, Mandibular Nerve Block, Oral Medication, Trigger Point Injection

Chang, S. , Jun, B. , Choi, J. , Kim, J. and Jang, Y. (2015) Successful Treatment of a Case of First Bite Syndrome without Any Cause. World Journal of Neuroscience, 5, 331-333. doi: 10.4236/wjns.2015.55031.