Management of Oromandibular Dystonia: A Case Report and Literature Update

Abstract

Oromandibular dystonia (OMD) is a movement disorder characterized by involuntary, paroxysmal, and patterned muscle contractions of varying severity resulting in sustained spasms of masticatory muscles, affecting the jaws, tongue, face, and pharynx. It is most commonly idiopathic or medication-induced, but peripheral trauma sometimes precedes the condition. We present a case report of a 26-year-old female patient who suffered repetitive bouts of hemifacial muscle contractions for 2 years on closing the mouth which interfered in patient's well-being and quality of life by hampering her ability to eat and talk and to the extent of inability to breath due to contractions of her neck muscles. Prompt diagnosis of a chronic oromandibular dystonia jaw closing type led to the control of the spasmodic muscle contractions within 24 hours and alleviation of patients fear of morbidity.

Clinical evaluation of non-motor symptoms in jaw closing dystonia

“…Recently, Gnand Nag [24] reported clinical findings of a case of oromandibular dystonia in a 26-yearold female who complained of painful constrictive movements on the right side of the face and a feeling of constriction in the neck, which led to difficulty with breathing. Their patient experienced spontaneous, intermittent, unilateral paroxysmal, and severely painful involuntary spasmodic contractions on the right half of the face, which were repetitive throughout the day and could be relieved by conscious opening of the mouth, only to reappear again with the next occlusal contact.…”

Oromandibular Dystonia - A Purely Clinical Diagnostic Case Report

“…It can also be categorized based on etiology as primary dystonia which is idiopathic or inherited; while, secondary dystonia advances after traumatic or surgical incidents, brain diseases, and medications [2]. Head and neck dystonia manifest clinically by the presence of involuntary sustained, forceful muscle contractions, and characteristic rhythmic movements and abnormal posture [3]. Craniocervical manifestations of dystonia affect the person's quality of life by interfering with the ability to speak and swallow and in social interaction.…”

“…Cranial dystonia is a broad description for dystonia that affects any part of the head [1]. Dystonia that affects the facial muscles and lips of musicians who play wind instruments is called embouchure dystonia [2,3]. Dystonia that specifically affects the tongue is called lingual dystonia.…”

Case Report: Isolated lingual dystonia

“…It can manifest as jaw clenching, jaw opening, jaw deviation and tongue protrusion, and can result in impaired speech, dysphagia and cosmetic disfigurement. It is often found in combination with dystonia of adjacent body regions 2 .…”

“…Dystonia has a large number of causes. Isolated lingual dystonia of idiopathic nature is rarely reported 2 . Here we report a case of isolated lingual dystonia of idiopathic etiology.…”