![]() The pain was described as sharp and stabbing type. On detailed history, the patient informed that he experiences acute pain (10/10 on Numerical Rating Scale) on having the first bite of meal and gradually subsides on subsequent intake of food and subsides completely in few minutes after completion of meal. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, on July 7, 2019, with a chief complaint of pain in the left and right lower jaw area for 5 months while having food. We report a unique case of IFBS occurring in a 35-year-old male patient.Ī 35-year-old male patient reported to the outpatient department of our institute, Maratha Mandal's Nathajirao G. Till date, there have been only six published reports of IFBS which includes five case reports and one case series, and none are from India. The etiology for the same still remains unknown. ![]() Apart from these, there are cases reported in the literature where the syndrome is not associated with any of the abovementioned causes and are referred to as idiopathic FBS (IFBS). The reason for occurrence of pain in these patients is due to loss of sympathetic innervations to the parotid gland postsurgically. FBS has also been reported postoperatively in cases of cervical lymph node dissection, temporomandibular joint (TMJ) replacement, carotid endarterectomy or ligation, resection of stylohyoid ligament in Eagle's syndrome, bimaxillary osteotomy, etc. The probable etiology for this syndrome could be associated with surgery to the neck, tumor of parapharyngeal space (PPS) or parotid gland. have proposed that FBS is caused by the loss of sympathetic innervations to the parotid gland, which remains the most accepted hypothesis regarding the pathogenesis of the syndrome. The pain subsides gradually by the subsequent bites, and the pain is worst with the first bite and first meal of the day. It was first described by Netterville (1998) as severe parotid pain elicited on the first bite of a meal without any prodromal symptoms. Some of which can be diagnosed clinically while others can be diagnosed only on imaging.įirst bite syndrome (FBS) is one such condition which does not show any kind of abnormality on imaging. ![]() A broad spectrum of pathological conditions can affect the parotid glands. ![]()
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