We think that patients with orofacial pain consistent with FBS should undergo MRI of the face to rule out parotid or parapharyngeal space lesion. These findings suggest that the gustatory-salivary reflex via the chorda tympani fibers is involved in the development of pain of the idiopathic FBS.
Conservative therapy, including drug therapy and self-care, began with a limited effect initially, but the severity of pain improved slowly and at six months, his symptoms had almost resolved. Although chewing gauze did not induce pain, the application of acetic acid, which stimulates salivation to the anterior part of the tongue, triggered sharp pain in the parotid glands. MRI of the head and face did not detect any intracranial or extracranial pathologic lesion, with the exception of hypertrophy of parotid glands. On examination, the parotid glands, temporomandibular joints and teeth were normal. Symptoms were severe enough to hinder his quality of life. The intense pain appeared to be related to the first few bites eaten at every meal, and the pain improved with each subsequent bite. The patient complained of severe pain in the parotid region and impacted upper wisdom teeth, which had been occurring for two months. We report on a 33-year-old man, with no prior surgical history, who presented with bilateral orofacial pain consistent with FBS. The cause is unclear but, may be related to nerve impairment from surgery or other conditions. First bite syndrome (FBS) is an unusual disease, which is characterized by excruciating pain in the parotid region after the first bite, and is usually seen after parapharyngeal space surgery. First bite syndrome is characterized as pain in the parotid (salivary gland) gland or lower jaw area (mandibular region) at the first bite and, subsequently improves with each bite. Need to eat a little between meals I think. The lettuce with dressing on it made me cramp, as did the teriyaki chicken. I was ecstatic But then on Friday night, the FBS syndrome came with dinner. My hands and feet are tingling away tonight. I even experimented with a bite of toasted bagel and cream cheese and I successfully ate my entire half (the smaller half) with very small bites and very good chewing. I’m still sleeping loads! Good luck, you can do this Quote from AMMurphy: Hopefully it was enough to ensure it doesn’t come back. I’d completed 5 cycles, (got changed to Folfox as unfortunately the capecitabine tablets gave me serious diarrhea, so my treatment increased from 3 months to 6 months, but only completed 3 months in the end because of coronavirus. Just keep your team informed of all your symptoms, ( best to keep a diary), and they will adjust your dose if necessary, So pleased your treatment is continuing as mine has now been cancelled. My oncologist also reduced the oxyleplatin by 20% as the pins and needles was really bad, and that helped too. It took me 3 changes to get the sickness right so do ask for a change of anti sickness drugs if you’re still feeling nauseous. Hope the effects settle down for you, i have a feeling it might be something i will have as im prone to the cold but its manageable and minor in thd scheme of what side effects j might still be in store for! Take care AMMurphy Everyone told not to make me cry as yes it hurts! Had call to say MRI on liver showed no sign of cancer but had to hold back my tears of relief! Im feeling a bit nauseus at the moment but think its going to bed after dinner whereas im usually quite active.
I am v sensitive to the cold anyway but within the 1st 24 hours ive adapted well in house with gloves, socks and no cold food or drinks. Thank godness it happened at hosp else ws would both have panicked. Discovered i rarely breath through my nose which is now being practised all the time! Had extra drugs given and heat pad on throat to go home. 5 minutes before the end of the infusion the temperature had dropped it was about 4.30pm when i spoke i then thought i couldnt breathe. I had my 1st CAPOX on tuesday and have reacted to the cold.