ReviewCurrent pain and headache reports2021
First Bite Syndrome: What Neurologists Need to Know.
Review in Current pain and headache reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Advances in orofacial pain research: a bibliometric analysis.Frontiers in neurology · 2025Pooled it
- Guidelines for the Use of Botulinum Toxin in Otolaryngology From the Korean Society of Laryngology, Phoniatrics and Logopedics Guideline Task Force.Clinical and experimental otorhinolaryngology · 2023Guideline
- Scar neuroma infiltration to treat post-surgical first bite syndrome.Interventional pain medicine · 2026Article
- First byte syndrome successfully treated with parotid gland botulinum toxin injection.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Temperature-related atypical first-bite syndrome: a rare case report.Frontiers in oral health · 2025Article
- First Bite Syndrome: A Rare Post-Surgical Complication Following a Carotid Body Tumor Excision.Cureus · 2025Article
- Prophylactic use of duloxetine hydrochloride in oxaliplatin-induced first-bite syndrome.International cancer conference journal · 2025Article
- A Narrative Review on Pain Management in Head and Neck Cancer: Integrating Multimodal Analgesia and Interventional Procedures.Anesthesiology and pain medicine · 2024Review
- Successful management of an idiopathic first bite syndrome: A case report and review.Clinical case reports · 2024Article
- Management of Parapharyngeal Space Tumors: Clinical Experience with a Large Sample and Review of the Literature.Current oncology (Toronto, Ont.) · 2023Review
- Idiopathic parotid pain: a rare clinical presentation of first bite syndrome without history of head and neck surgery or underlying malignancies.Journal of surgical case reports · 2022Article
- State of Rehabilitation Research in the Head and Neck Cancer Population: Functional Impact vs. Impairment-Focused Outcomes.Current oncology reports · 2022Review
- First Bite Syndrome after Carotid Endarterectomy for High Carotid Bifurcation and Extensive Lesions: Two Case Reports and Literature Review.NMC case report journal · 2022Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose of reviewThough first bite syndrome is well known in surgical settings, it is not commonly included in the differential for sharp paroxysmal facial pain in the neurology literature. This paper will highlight the clinical features and relevant anatomy of first bite syndrome, with the goal of helping clinicians differentiate this from other similar facial pain disorders. RECENT
findingsFirst bite syndrome is severe sharp or cramping pain in the parotid region occurring with the first bite of each meal and improving with subsequent bites. Pathophysiology has been attributed to imbalanced sympathetic/parasympathetic innervation of the parotid gland. This is seen most typically in the post-surgical setting following surgery in the parotid or parapharyngeal region, but neoplastic etiologies have also been reported. It is common for patients to present with concurrent great auricular neuropathy and/or Horner's syndrome. Evidence regarding treatment is limited to case reports/series, however, botulinum toxin injections and neuropathic medicines have been helpful in select cases. It is critical for clinicians to be able to differentiate first bite syndrome from other paroxysmal facial pain. To help with this, we have proposed diagnostic criteria for clinical assessment. Patients often improve gradually over time, but symptomatic treatment with botulinum toxin or neuropathic medicine may be required.
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Registered trials
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