It is associated with hyposalivation, as bacteria are able to enter the ductal system against the diminished flow of saliva. There may be swollen salivary glands even without acute infection, possibly caused by autoimmune involvement. Dysgeusia – altered taste sensation (e.g., a metallic taste) and dysosmia, altered sense of smell. Intraoral halitosis –  possibly due to increased activity of halitogenic biofilm on the posterior dorsal tongue (although dysgeusia may cause a complaint of nongenuine halitosis in the absence of hyposalivation). Burning mouth syndrome – a burning or tingling sensation in the mouth. Saliva that appears thick or ropey. Mucosa that appears dry. A lack of saliva pooling in the floor of the mouth during examination. Dysphagia – difficulty swallowing and chewing, especially when eating dry foods. Food may stick to the tissues during eating. The tongue may stick to the palate, causing a clicking noise during speech, or the lips may stick together. Gloves or a dental mirror may stick to the tissues. Fissured tongue with atrophy of the filiform papillae and a lobulated, erythematous appearance of the tongue. Saliva cannot be "milked" (expressed) from the parotid duct. Difficulty wearing dentures, e.g., when swallowing or speaking. There may be generalized mucosal soreness and ulceration of the areas covered by the denture. Mouth soreness and oral mucositis. Lipstick or food may stick to the teeth. A need to sip drinks frequently while talking or eating. Dry, sore, and cracked lips and angles of mouth. Thirst.However, sometimes the clinical findings do not correlate with the symptoms experienced.
Surgery is also a treatment option. In epilepsy surgery (focal resection or hemispherectomy) the part of the brain which creates the abnormal electrical current through the brain must be resected, but the surgery is very complicated and needs to be performed by expert surgeons in epilepsy reference centers. None of these treatments, with the exception of some metabolic disorders with specific treatments available, have shown any efficacy at avoid long-term consequences of the disease. Prognosis
The prognosis is usually poor. Mortality rate is high during early infancy and almost half of the children die by 2 years of age. In the patient with severe phenotype, even when optimal treatment is initiated promptly, the prognosis remains poor. Most of the survivors suffer from psychomotor impairment and develop electroclinical features of other epilepsy syndromes (i.e Lennox- Gastaut syndrome). In patients with reduced phenotype, if there is early treatment initiated the better developmental outcome can be observed. Epidemiology
The prevalence estimates among EME are of <1 / 1 000 000. References


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