Oromandibular dystonia: a case report of the lateral pterygoid muscle involvement and treatment with botulinum toxin A

The objective of the present case report is to punctuate the importance of individualized therapy procedures and the accurate diagnosis of the muscles involved in oromandibular dystonia and underline the role of electromyography (EMG). We report a woman who presented sustained jaw movement towards the left, severe difficulty in jaw opening and jaw protrusion. The patient was treated with injections of botulinum A toxin in lateral pterygoid, masseter, platysma, sternoclidomastoid, temporalis muscles with EMG guidance. She experienced an 80% reduction of her symptoms after the first injection. In jaw deviation dystonia symptoms impressively respond to botulinum toxin treatment of the pterygoid muscle. Individualized therapy procedures are necessitated.