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Hereditary sensory and autonomic neuropathy type IV or Congenital insensitivity to pain with anhydrosis is a rare autosomal recessive disorder. It is characterized by absence of small myelinated and unmyelinated sympathetic nerves resulting in pain and temperature insensitivity. We report a case of a 15 year old boy with hereditary sensory and autonomic neuropathy type IV associated with bifid tongue which is an extremely rare oral presentation and not often reported in literature.

Bifid tongue in hereditary sensory and autonomic neuropathy type IV