Nocturnal tongue biting beyond epilepsy: sleep-related facio-mandibular myoclonus —a diagnostic and therapeutic challenge

We present a case of sleep-related facio-mandibular myoclonus (FMM) in a man in the third decade of life with recurrent tongue-biting episodes during sleep onset. Video-polysomnography and video-electroencephalogram revealed myoclonic jaw jerks without epileptiform activity. The episodes were associated with stress and improved with clonazepam and non-pharmacological interventions. This case highlights sleep-related FMM as a rare, under-recognised cause of sleep-related tongue biting, distinct from epilepsy and bruxism. Early diagnosis through neurophysiological studies is crucial to prevent misdiagnosis and ensure accurate treatment.