Resolution of burning mouth syndrome symptoms after galcanezumab: A case report

Background Burning mouth syndrome (BMS) is an orofacial pain syndrome where patients have chronic pain without a clear underlying lesion or cause. This can significantly impair patients’ quality of life, and no definitive treatments exist at this time. Case The case presented here describes a case of BMS with symptom resolution after starting galcanezumab. The patient was a 60-year-old female with recently diagnosed systemic lupus erythematosus and Sjögren’s disease who was first seen by neurology for chronic migraine, but on subsequent visit noted a burning sensation of her tongue as well as extremity paresthesias. The orofacial pain was found to be consistent with BMS based on International Classification of Headache Disorders 3rd Edition (ICHD-3) criteria after workup for this and her other symptoms. The migraine was first treated with metoprolol, but when this was unsuccessful, she was switched to galcanezumab. After starting this, the BMS symptoms resolved, and on continued follow up it was noted that when she delayed receiving galcanezumab the symptoms did return until she took the medicine again. Conclusion This case expands our understanding of BMS by demonstrating a potential relationship between migraine and BMS. This relationship can help us understand the pathophysiology and potentially reveal new treatment options for this syndrome.