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Case Reports
. 2024 Apr 1;20(4):653-656.
doi: 10.5664/jcsm.10966.

A rare case of tongue biting during sleep in childhood

Inês Cascais  1 , Joanna Ashworth  1 , Lúcia Ribeiro  2 , Joel Freitas  2 , Marta Rios  1
Affiliations
Case Reports

A rare case of tongue biting during sleep in childhood

Inês Cascais et al. J Clin Sleep Med. .

Abstract

Bleeding tongue-biting episodes during sleep are a rare and alarming situation that can negatively impact the child's and parents' sleep, affecting their quality of life. Although highly suggestive of epilepsy, a differential diagnosis should be made with sleep-related movement disorders such as bruxism, hypnic myoclonus, facio-mandibular myoclonus, and geniospasm when this hypothesis is excluded. The clinical history, electroencephalogram, and video-polysomnography are essential for diagnostic assessment. Treatment with clonazepam can be necessary in the presence of frequent tongue biting that causes severe injuries and sleep disturbance. This study reports the challenging case of managing and diagnosing a 2-year-old boy with recurrent tongue biting during sleep since he was 12 months old, causing bleeding lacerations, frequent awakenings, and significant sleep impairment with daytime consequences for him and his family.

Citation: Cascais I, Ashworth J, Ribeiro L, Freitas J, Rios M. A rare case of tongue biting during sleep in childhood. J Clin Sleep Med. 2024;20(4):653-656.

Keywords: facio-mandibular myoclonus; geniospasm; pediatric; sleep; tongue biting.

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Conflict of interest statement

All authors have read and approved the manuscript. Work for this study was performed at the Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António (CMIN-CHUdSA), Porto, Portugal. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Right (A) and left (B) laceration of the tongue and ulceration due to nocturnal tongue biting.
Figure 2
Figure 2. Level 1 polysomnography with supplementary electroencephalogram channels, masseters, mentalis, and orbicularis oculi electromyography montages showing a cluster of irregularly brief bursts during NREM stage 2 sleep (A) and REM sleep without atony (B).
NREM = non–rapid eye movement, REM = rapid eye movement.
See this image and copyright information in PMC

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