Idiopathic first bite syndrome treated with repeated stellate ganglion blocks: a case report

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  • KUROKAWA Hiromi
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • TAKEZAKI Toru
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • KAWAGUCHI Ryoji
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • NAKAO Miwako
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • SATO Nobuyoshi
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • UNETANI Hideo
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • MIYAZAKI Akiko
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital
  • KAGEMOTO Ruriko
    Department of Anesthesiology and Intensive Care Medicine, Hiroshima Prefectural Hospital

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Other Title
  • 特発性ｆｉｒｓｔ　ｂｉｔｅ　ｓｙｎｄｒｏｍｅに対して星状神経節ブロックが有効であった症例
  • トクハツセイ first bite syndrome ニ タイシテ セイジョウ シンケイセツ ブロック ガ ユウコウ デ アッタ ショウレイ

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Abstract

First bite syndrome (FBS) is a rare disease causative of pain in the parotid gland region at the first bite of each meal. We report patient with long-standing idiopathic FBS whose pain disappeared after repeated stellate ganglion blocks (SGB). A man aged in his thirties had 6-month history of pain in the parotid gland region that occurred immediately after the first bite of every meal. He did not have any surgery done on the right parapharyngeal area. Pain in the right parotid gland region developed 6 months before he was referred to us. Medications did not decrease the pain and the pain was so severe that the patient could not have any food. He received enteral alimentation and diclofenac. He rated the first bite pain 80 and the pain after the first bite 100 on a visual analog scale of 100. The pain did not change after 5 repeats of SGB; however, the pain after the first bite decreased after 6 repeats of SGB. The first bite pain decreased later. The pain completely disappeared after 16 repeats of SGB. The pain did not recur 2.5 years after cessation of treatment.

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