A Challenging Case of Recurrent Nocturnal Tongue Biting in an Infant

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A Challenging Case of Recurrent Nocturnal Tongue Biting in an Infant

Case Report

Jorge Rodrigues

Pediatric Department, Centro Hospitalar Tondela-Viseu, Viseu, Portuga
https://orcid.org/0000-0002-3545-8834

Joana Teixeira Carvalho

Pediatric Department, Hospital Pedro Hispano, Senhora da Hora, Portugal
https://orcid.org/0000-0001-6561-2153

Ricardo Liz Almeida

Pediatric Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
https://orcid.org/0000-0001-6069-767X

Núria Madureira

Sleep and Ventilation Laboratory, Pediatric Department, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
https://orcid.org/0000-0002-4738-9880

DOI: https://doi.org/10.25754/pjp.2022.25240

Abstract

Sleep disorders are common in children and adolescents, with a major impact on their quality of life. Although considered a likely sign of an underlying sleep or neurological disorder, nocturnal awakenings are usually of psychogenic or behavioral nature. Clinical history, physical examination, brain imaging, and polysomnographic studies can be necessary to establish an appropriate differential diagnosis, particularly in the presence of alarm signs. Tongue biting is considered to be highly suggestive of an epileptic seizure, justifying the exclusion of this diagnosis, although it may occur in psychogenic events and sleep-related movement disorders as well, such as geniospasm or facial myoclonus. This study presents a curious and challenging case of recurrent tongue biting during sleep of unknown etiology.