With ludwings angina does the neck swell first or under the tounge ?

Neck: And side of the face usually first, then tongue..

Tongue: The infection starts like a skin infection under the tongue or the gum/teeth.. The swelling starts there and lifts the other tissues and the tongue will then obstruct the breathing and swallowing as it is pushed against the walls of the mouth and throat from the swelling that usually starts under it.

Ludwig's Angina: The infection starts in the floor of the mouth, usually from an infected tooth. As with any infection, the infections spreads locally at first, follows the path of least resistance through tissue, blood vessels or lymphatics and may develop in any direction until it becomes symptomatic. See the following for more information: http://www.Nlm.Nih.Gov/medlineplus/ency/article/001047.Htm.