Dystonia is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both that are typically patterned, twisting, and sometimes tremulous. It is often initiated or worsened by voluntary action and associated with overflow muscle activation. In this article we report a case of severe oromandibular dystonia, which is a specific form of dystonia characterized by involuntary, action-induced tonic or clonic spasms of the masticatory, lingual, and pharyngeal musculature. Episodes of repeated tongue biting in a 17-month-old girl caused her to stay in the PICU for 4 weeks. These episodes were the consequence of dystonia induced by a perinatal stroke. We highlight the specific dental management that enabled us to treat the child without extractions. Facing this type of complex illness, we insist on the importance of interdisciplinary work with the goal of avoiding outdated techniques. The use of botulinum toxin seemed relevant.
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Article Synopsis
- Oromandibular dystonia (OMD) is a condition causing muscle contractions in the jaw and related areas, and this study analyzed the effects of botulinum toxin (onabotulinumtoxinA) as a treatment.
- A meta-analysis of 26 studies with 1103 patients showed that 96.2% experienced a positive response to the injections, with 88.9% achieving significant improvement of over 50%.
- Although 17.8% of patients had adverse effects, mainly dysphagia (10.1%), the overall findings suggest that botulinum toxin is an effective treatment for OMD but further studies are needed for more conclusive results.
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