scholarly journals Jaw-Closing Oromandibular Dystonia Induced by Speaking in a Patient with Systemic Sclerosis

2018 ◽  
Vol 8 (3) ◽  
pp. 170-173
Author(s):  
ATM Tanveer Hasan ◽  
Syed Jamil Abda ◽  
Sabrina Yesmin ◽  
Shamim Ahmed

Oromandibular dystonia is a rare form of focal dystonia caused by involuntary spasms of masticatory, lingual and pharyngeal muscles. Here we describe a 53-year-old edentulous woman with systemic sclerosis who presented with dysarthria due to bilateral contraction of her masseter muscles during speaking. An anticholinergic medication was prescribed instead of botulinum toxin injection. Her condition markedly improved after medication. We suspected that edentulosity caused an impairment of proprioception in the oral cavity leading to subsequent development of dystonia.J Enam Med Col 2018; 8(3): 170-173

2017 ◽  
Vol 38 (2) ◽  
pp. 192-198 ◽  
Author(s):  
Gunwoo Park ◽  
Young-Chan Choi ◽  
Jung-Hee Bae ◽  
Seong-Taek Kim

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A465-A466
Author(s):  
Caleb Hsieh ◽  
Nancy Hsu ◽  
Aaron Thomas ◽  
Melisa Chang ◽  
Armand Ryden ◽  
...  

Abstract Introduction Abnormalities of the upper airway are an underrecognized cause of obstructive sleep apnea (OSA). Oromandibular dystonia (OMD) is characterized by involuntary contractions of the masticatory, facial, pharyngeal or laryngeal muscles usually resulting in pain, dysarthria, dysphagia, or impaired mastication. We present a patient with OMD manifest as episodic OSA and sleep maintenance insomnia treated effectively with botulinum toxin injections of the temporalis and masseter muscles. Report of Case A 51-year-old man was referred for fatigue and insomnia. History was notable for prior facial trauma requiring jaw surgeries with titanium prostheses and chronic OMD requiring periodic botulinum toxin injections of the temporalis and masseter muscles. An initial home sleep test (HST) 43 days after the last botulinum toxin injection showed a respiratory event index of 6.5 events/hour. Given severity of symptoms, positive airway pressure (PAP) was initiated; however, due to poor tolerance and persistent symptoms, he was referred for attended polysomnography (PSG). The PSG was done 13 days after an injection and showed apnea-hypopnea index (AHI) of 0 events/hour. Because the patient continued to endorse episodically severe symptoms that he felt paralleled the severity of OMD and waning of botulinum toxin effect, a repeat PSG was performed at a subjective botulinum toxin effect nadir. This PSG done at 83 days post-injection demonstrated AHI of 84 events/hour. PAP therapy was thus resumed, and the patient’s symptoms improved with increased frequency of botulinum toxin treatments. Conclusion To our knowledge, this is the first report of OSA due to chronic dystonia of the facial muscles. Botulinum toxin has demonstrated benefit in the treatment of OMD with efficacy generally lasting three to six months. While PAP remains the first-line treatment for OSA, in patients with structural or functional abnormalities of the upper airway, it is important to also consider treatment of the underlying anatomical defect.


1989 ◽  
Vol 98 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Andrew Blitzer ◽  
Paul E. Greene ◽  
Mitchell F. Brin ◽  
Stanley Fahn

Dystonia is a neurologic disorder characterized by abnormal, involuntary movements causing twisting and turning postures; it is postulated to be a disorder of central motor processing. The dystonias, when classified by region of the body involved, have been characterized as focal, segmental, and generalized. Focal dystonia can affect jaw mechanics, leading to forceful contraction of the jaw muscles and resulting in inappropriate deviation of the jaw. Localized injections of botulinum toxin have been used successfully in the management of other focal or segmental dystonias. We have treated 20 oromandibular dystonia patients with botulinum toxin. Six patients had only jaw and tongue involvement; 11 had blepharospasm and jaw involvement; and three had jaw involvement as part of a more generalized dystonia. Five patients had been diagnosed originally and treated as having temporomandibular joint syndrome. All but one of the patients had improvement of their symptoms with the toxin injections. The patients averaged 47% improvement with the injections.


2021 ◽  
Vol 14 (1) ◽  
pp. 133-136
Author(s):  
Courtney Gilbert ◽  
Michelle Sauer ◽  
JenFu Cheng

Lesch-Nyhan syndrome is a genetic metabolic disorder often involving dystonia and self-mutilating behavior. This case report describes a 13-year-old boy with Lesch-Nyhan syndrome and self-mutilating behavior who received botulinum toxin injections to his bilateral masseter muscles after failing multiple other treatments. Following injections, the patient had reduction in self-biting, along with improvements in speech, mastication and feeding observed in speech therapy. Botulinum toxin injections to the masseters may help to improve oromotor function and reduce self-mutilating behaviors in children with Lesch-Nyhan syndrome who have failed more conservative treatments, providing opportunity for improved functional status and patient safety. Further investigation is indicated to establish optimal dosing. Additionally, the mechanism for the reduction of self-mutilating behavior is unclear and justifies additional investigation.


2019 ◽  
Vol 10 (02) ◽  
pp. 346-348 ◽  
Author(s):  
Rajesh Verma ◽  
Chetan Shettigar

ABSTRACTOromandibular dystonia is characterized by persistent contractions and repetitive spasms of masticatory muscles surrounding the oral cavity and lingual muscles. The lingual dystonia is rare hyperkinetic movement disorder, often occurring secondary to drugs. The common drugs which can cause acute focal dystonia are neuroleptics, antiemetics, and antipsychotics. Isolated lingual dystonia is a rare form of disabling focal dystonias. We report a young female, who developed tongue dystonia in isolation and responding favorably to antihistaminics. The physicians are advised to make inquiry about administered drugs in isolated lingual dystonia.


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