Uniform enlargement of the tongue in infancy and in childhood is generally associated with cretinism, mongolism or some other types of idiocy. In cases of thyroid deficiency the abnormal size of the tongue is due to infiltration with mucoid material. In thirty-eight mongolian idiots, three of whom were Negroes, we usually found the tongue furrowed, and we felt that its protrusion was not due to an actual increase in its size. In other types of idiots the apparently large tongue protrudes from the mouth because of faulty coordination. In cases of myotonia congenita, which is characterized by great hypertrophy of the voluntary musculature, biopsy of the muscles in infancy reveals that the structure is normal histologically.
The first knowledge of macroglossia has been attributed to Galenus. At his time and long afterward macroglossia signified any lesion of the tongue which caused it to swell. In the literature, under macroglossia are
BRONSTEIN IP, ABELSON SM, JAFFÉ RH, BONIN GV. MACROGLOSSIA IN CHILDRENREVIEW OF THE LITERATURE, REPORT OF A CASE OF TRUE MUSCULAR HYPERTROPHY AND A SUGGESTED CLASSIFICATION. Am J Dis Child. 1937;54(6):1328–1343. doi:10.1001/archpedi.1937.01980060120012