scholarly journals “Orofacial Dystonia—A Silent Killer”: Mandibular Fractures with Orofacial Dystonia, A Report of a Case and Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Anand deep Shukla ◽  
G. Srikanth ◽  
A. Chitra ◽  
Anupam Singh ◽  
Sunil Nayak
Keyword(s):  
Old Age ◽  
Cervical Dystonia ◽  
Geriatric Patient ◽  
Masticatory Muscles ◽  
Mandibular Fractures ◽  
Reconstruction Plate ◽  
Spasmodic Contraction ◽  
The Right

Mandibular parasymphysis fracture is very commonly observed especially in old age when there is resorptions of the alveolar ridges. In cervical dystonia, there is centrally mediated disease in which there is uncontrolled and spasmodic contraction of the facial and the masticatory muscles. Due to the application of this sudden and uncontrolled force, there is a tendency of the bone to unfavourably remodel and weaken. The case presented here is of a geriatric patient who presented to us with a fracture at the right parasymphysis and left dentoalveolar region of the mandible and was suffering from cervical dystonia. Management of this case posed a challenge in every step, and it needed a resurgery where the fracture was managed by the placement of reconstruction plate. Not many cases in the literature have been reported where dystonic movements have resulted in the fracture of the mandible.

Smartphone addiction and the relationship with head and neck pain and electromiographic activity of masticatory muscles

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Fabiana Foltran Mescollotto ◽  
Érica Brito Gonçalves ◽  
Ester Moreira de Castro Carletti ◽  
Ana Beatriz Oliveira ◽  
Elisa Bizetti Pelai ◽  
...  
Keyword(s):  
College Students ◽  
Neck Pain ◽  
Head And Neck ◽  
Muscle Activity ◽  
Neck Region ◽  
Masticatory Muscles ◽  
Smartphone Addiction ◽  
Before And After ◽  
Smartphone Use ◽  
The Right

Background: Excessive use of smartphones may be associated with behavioral and physical health changes and might cause musculoskeletal alterations in the head and neck region. Objective: To evaluate the prevalence of smartphone addiction in college students and its correlation with symptoms of head and neck pain and masticatory and trapezius muscle activity while resting, before and after smartphone use. Methods: Twenty university students participated in the study. They answered the Smartphone Addiction Scale and the Fonseca Anamnestic Index. Next, the participants were seated and prepared for electromyography through the placement of surface electrodes on the masseter, temporal, and trapezius muscles. Rest condition data were collected for 10 seconds before and after 30 minutes of smartphone use. Results: The results showed that 35% of the evaluated individuals were classified as smartphone addicted and 35% reported no head or neck pain in the previous 30 days. There was no association between smartphone use and head and neck pain. In the electromyography, there was an increase in RMS values after smartphone use in the right and left masseter muscles and the left trapezius. Conclusion: College students presented a high prevalence of smartphone addiction and head and neck pain, but these were not statistically associated. There was a change in muscle activity only in the right trapezius muscles before and after 30 minutes of smartphone use. These findings are contrary to the current belief that the use of smartphones correlates with pain in the neck region and changes in the electrical muscle activity, leading to fatigue in the cervical muscles.

Spontaneous craniocervical osseous fusion caused by cervical dystonia

2001 ◽  
Vol 95 (1) ◽  
pp. 115-118 ◽  
Author(s):  
Ralf Weigel ◽  
Michael Rittmann ◽  
Joachim K. Krauss
Keyword(s):  
Cervical Dystonia ◽  
Three Dimensional ◽  
Sternocleidomastoid Muscle ◽  
Facet Joints ◽  
Content Type ◽  
History Of ◽  
Posterior Neck ◽  
Atlantoaxial Rotatory Fixation ◽  
The Right ◽  
Rotatory Fixation

✓ The authors report on a 31-year-old man with spontaneous craniocervical osseous fusion secondary to cervical dystonia (CD). After an 8-year history of severe CD, the patient developed a fixed rotation of his head to the right. Three-dimensional computerized tomography reconstructions revealed rotation and fixation of the occiput and C-1 relative to C-2, which was similar to that seen in atlantoaxial rotatory fixation. There was abnormal ossification of the odontoid facet joints and ligaments. Additional ossification was observed in the cervical soft tissue bridging the lateral mass of C-1 and the occiput. The patient underwent partial myectomy of the dystonic left sternocleidomastoid muscle and selective posterior ramisectomy of the right posterior neck muscles; postoperatively he experienced relief of his neck pain. In patients with CD refractory to conservative treatment, the appropriate timing of surgical treatment is important.

scholarly journals Botulinum toxin injection changes resting state cerebellar connectivity in cervical dystonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pavel Hok ◽  
Lenka Hvizdošová ◽  
Pavel Otruba ◽  
Michaela Kaiserová ◽  
Markéta Trnečková ◽  
...  
Keyword(s):  
Functional Mri ◽  
Resting State ◽  
Cervical Dystonia ◽  
Botulinum Neurotoxin ◽  
Botulinum Toxin Injection ◽  
Clinical Severity ◽  
Before And After ◽  
Positive Correlations ◽  
Using Data ◽  
The Right

AbstractIn cervical dystonia, functional MRI (fMRI) evidence indicates changes in several resting state networks, which revert in part following the botulinum neurotoxin A (BoNT) therapy. Recently, the involvement of the cerebellum in dystonia has gained attention. The aim of our study was to compare connectivity between cerebellar subdivisions and the rest of the brain before and after BoNT treatment. Seventeen patients with cervical dystonia indicated for treatment with BoNT were enrolled (14 female, aged 50.2 ± 8.5 years, range 38–63 years). Clinical and fMRI examinations were carried out before and 4 weeks after BoNT injection. Clinical severity was evaluated using TWSTRS. Functional MRI data were acquired on a 1.5 T scanner during 8 min rest. Seed-based functional connectivity analysis was performed using data extracted from atlas-defined cerebellar areas in both datasets. Clinical scores demonstrated satisfactory BoNT effect. After treatment, connectivity decreased between the vermis lobule VIIIa and the left dorsal mesial frontal cortex. Positive correlations between the connectivity differences and the clinical improvement were detected for the right lobule VI, right crus II, vermis VIIIb and the right lobule IX. Our data provide evidence for modulation of cerebello-cortical connectivity resulting from successful treatment by botulinum neurotoxin.

scholarly journals Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

2022 ◽  
pp. 98-100
Author(s):  
A. A. Sultanov ◽  
Y. Y. Pervov ◽  
A. K. Yatsenko ◽  
M. A. Sultanova ◽  
D. O. Drozdova
Keyword(s):  
Physical Examination ◽  
Temporomandibular Joint ◽  
Orthodontic Treatment ◽  
Clinical Case ◽  
Mouth Opening ◽  
Integrated Approach ◽  
Masticatory Muscles ◽  
Temporomandibular Joint Dysfunction ◽  
The Right ◽  
Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

Urinary incontinence with special reference to the geriatric patient

1999 ◽  
Vol 55 (3) ◽  
pp. 15-19
Author(s):  
M. Papadopoulos ◽  
R. Jordaan
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Old Age ◽  
Geriatric Patient ◽  
The Elderly ◽  
Specific Reference ◽  
Economic Costs ◽  
Different Types ◽  
Life Threatening

Problems involving the urinary tract, particularly urinary incontinence, tend to become more common with age. Urinary incontinence is a prevalent problem in the elderly and its medical, social and economic costs are significant. Patients are often too embarrassed or unwilling to seek treatment, as it is often seen as an inevitable corollary of old age, as it is not considered a life-threatening ailment and also because they assume that it is untreatable. The physiotherapist can play a very important role in both the prevention and management of incontinence, but sadly, very few physiotherapists are prepared to take this challenge. The aim of this review is to provide information, with specific reference to the elderly, regarding the prevalence, risk factors and causes of incontinence. The history and examining of the incontinent patient are discussed and management of the different types of incontinence are mentioned.

scholarly journals Stabilization of Mobile Mandibular Segments in Mandibular Reconstruction: Use of Spanning Reconstruction Plate

2012 ◽  
Vol 5 (3) ◽  
pp. 123-126 ◽  
Author(s):  
Yan Lin Yap ◽  
Jane Lim ◽  
Wei Chen Ong ◽  
Matthew Yeo ◽  
Hanjing Lee ◽  
...  
Keyword(s):  
Conventional Technique ◽  
Mandibular Reconstruction ◽  
Wide Resection ◽  
Rigid Fixation ◽  
Reconstruction Plate ◽  
Modified Technique ◽  
Intermaxillary Fixation ◽  
Segmental Mandibulectomy ◽  
Inferior Border ◽  
The Right

The fibular free flap is the gold standard for mandibular reconstruction. Accurate 3-dimensional contouring and precise alignment of the fibula is critical for reestablishing native occlusion and facial symmetry. Following segmental mandibulectomy, the remaining mandibular fragments become freely mobile. Various stabilization methods including external fixation, intermaxillary fixation, and preplating with reconstruction plate have been used. We describe a modification to the preplating technique. After wide resection of buccal squamous cell carcinoma, our patient had an 11-cm mandibular defect from the angle of the left mandible to the right midparasymphyseal region. A single 2.0-mm Unilock® (Synthes, Singapore) plate was used to span the defect. This was placed on the vestibular aspect of the superior border of the mandibular remnants before resection. Segmental mandibulectomy was then performed with the plate removed. The spanning plate was then reattached to provide rigid fixation. The fibular bone was contoured with a single osteotomy and reattached. The conventional technique involves molding of the plate at the inferior border of the mandible. This is time-consuming and not possible in patients with distorted mandibular contour. It is also difficult to fit the osteotomized fibula to the contoured plate. In comparison, the superiorly positioned spanning plate achieve rigid fixation of the mandible while leaving the defect completely free and unhampered by hardware, allowing space for planning osteotomies and easier fixation of the neomandible. Using this modified technique, we are able to recreate the original mandibular profile with ease.

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