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==Signs and symptoms==
==Signs and symptoms==
Clinical manifestations vary depending on the muscles involved, the extent of OMD, and its distribution.<ref name="Khan 2015">{{cite journal | last=Khan | first=Junad | last2=Anwer | first2=Hafiz Muhammad Moin | last3=Eliav | first3=Eli | last4=Heir | first4=Gary | title=Oromandibular dystonia | journal=The Journal of the American Dental Association | publisher=Elsevier BV | volume=146 | issue=9 | year=2015 | issn=0002-8177 | doi=10.1016/j.adaj.2014.09.001 | pages=690–693}}</ref> Impaired mastication, dysphagia, dysphonia (alteration of speech), mandibular disorders (TMD) such as open locks, unconscious mandibular opening and closing, and pulling and twisting of the mandible forward or laterally are examples of dysfunctions.<ref name="report on 21 cases">{{cite journal | last=Bakke | first=Merete | last2=Larsen | first2=Bo Madvig | last3=Dalager | first3=Torben | last4=Møller | first4=Eigild | title=Oromandibular dystonia—functional and clinical characteristics: a report on 21 cases | journal=Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology | publisher=Elsevier BV | volume=115 | issue=1 | year=2013 | issn=2212-4403 | doi=10.1016/j.oooo.2012.04.023 | pages=e21–e26}}</ref><ref name="vertical dimension">{{cite journal | last=Chidiac | first=José Johann | title=Oromandibular dystonia treatment following a loss of vertical dimension | journal=Dental Update | publisher=Mark Allen Group | volume=38 | issue=2 | date=March 2, 2011 | issn=0305-5000 | doi=10.12968/denu.2011.38.2.120 | pages=120–122}}</ref>
Clinical manifestations vary depending on the muscles involved, the extent of OMD, and its distribution.<ref name="Khan 2015">{{cite journal | last=Khan | first=Junad | last2=Anwer | first2=Hafiz Muhammad Moin | last3=Eliav | first3=Eli | last4=Heir | first4=Gary | title=Oromandibular dystonia | journal=The Journal of the American Dental Association | publisher=Elsevier BV | volume=146 | issue=9 | year=2015 | issn=0002-8177 | doi=10.1016/j.adaj.2014.09.001 | pages=690–693}}</ref> Impaired [[mastication]], [[dysphagia]], [[dysphonia]] (alteration of speech), mandibular disorders (TMD) such as open locks, unconscious mandibular opening and closing, and pulling and twisting of the [[mandible]] forward or laterally are examples of dysfunctions.<ref name="report on 21 cases">{{cite journal | last=Bakke | first=Merete | last2=Larsen | first2=Bo Madvig | last3=Dalager | first3=Torben | last4=Møller | first4=Eigild | title=Oromandibular dystonia—functional and clinical characteristics: a report on 21 cases | journal=Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology | publisher=Elsevier BV | volume=115 | issue=1 | year=2013 | issn=2212-4403 | doi=10.1016/j.oooo.2012.04.023 | pages=e21–e26}}</ref><ref name="vertical dimension">{{cite journal | last=Chidiac | first=José Johann | title=Oromandibular dystonia treatment following a loss of vertical dimension | journal=Dental Update | publisher=Mark Allen Group | volume=38 | issue=2 | date=March 2, 2011 | issn=0305-5000 | doi=10.12968/denu.2011.38.2.120 | pages=120–122}}</ref>


Indications of dystonic spasms include platysma spasms, mouth corner retractions, tongue dyskinesia, bruxism, lip pursing or sucking, facial grimacing, and nasal contractions.<ref name="Etiology, Diagnosis and Management" /> Breathing issues or dysarthria are also infrequently reported.<ref name="Schneider Hoffman 2011 pp. 355–358">{{cite journal | last=Schneider | first=Robert | last2=Hoffman | first2=Henry T. | title=Oromandibular dystonia: A clinical report | journal=The Journal of Prosthetic Dentistry | publisher=Elsevier BV | volume=106 | issue=6 | year=2011 | issn=0022-3913 | doi=10.1016/s0022-3913(11)60145-5 | pages=355–358}}</ref>
Indications of dystonic spasms include platysma spasms, mouth corner retractions, tongue [[dyskinesia]], [[bruxism]], lip pursing or sucking, facial grimacing, and nasal contractions.<ref name="Etiology, Diagnosis and Management" /> Breathing issues or [[dysarthria]] are also infrequently reported.<ref name="Schneider Hoffman 2011 pp. 355–358">{{cite journal | last=Schneider | first=Robert | last2=Hoffman | first2=Henry T. | title=Oromandibular dystonia: A clinical report | journal=The Journal of Prosthetic Dentistry | publisher=Elsevier BV | volume=106 | issue=6 | year=2011 | issn=0022-3913 | doi=10.1016/s0022-3913(11)60145-5 | pages=355–358}}</ref>


The onset of symptoms is more common in women and typically occurs between the ages of 40 and 70. The symptoms only show up when speaking or masticating, for example.<ref name="Etiology, Diagnosis and Management" /> Typically, patients list stress, talking, chewing, praying, and chewing objects as triggers.<ref name="Clinical, Etiological, and Therapeutic Features">{{cite journal | last=Gonzalez-Alegre | first=Pedro | last2=Schneider | first2=Robert L. | last3=Hoffman | first3=Henry | title=Clinical, Etiological, and Therapeutic Features of Jaw-opening and Jaw-closing Oromandibular Dystonias: A Decade of Experience at a Single Treatment | journal=Tremor and Other Hyperkinetic Movements | publisher=Ubiquity Press, Ltd. | volume=4 | issue=0 | date=April 30, 2014 | issn=2160-8288 | doi=10.5334/tohm.194 | doi-access=free | page=231}}</ref> Routine lab tests are typically normal.<ref name="report on 21 cases"/> Most of the time, it is reported that poor oral function is linked to social embarrassment, a lower quality of life, depression, and weight loss.<ref name="Etiology, Diagnosis and Management" />
The onset of symptoms is more common in women and typically occurs between the ages of 40 and 70. The symptoms only show up when speaking or masticating, for example.<ref name="Etiology, Diagnosis and Management" /> Typically, patients list stress, talking, chewing, praying, and chewing objects as triggers.<ref name="Clinical, Etiological, and Therapeutic Features">{{cite journal | last=Gonzalez-Alegre | first=Pedro | last2=Schneider | first2=Robert L. | last3=Hoffman | first3=Henry | title=Clinical, Etiological, and Therapeutic Features of Jaw-opening and Jaw-closing Oromandibular Dystonias: A Decade of Experience at a Single Treatment | journal=Tremor and Other Hyperkinetic Movements | publisher=Ubiquity Press, Ltd. | volume=4 | issue=0 | date=April 30, 2014 | issn=2160-8288 | doi=10.5334/tohm.194 | doi-access=free | page=231}}</ref> Routine lab tests are typically normal.<ref name="report on 21 cases"/> Most of the time, it is reported that poor oral function is linked to social embarrassment, a lower quality of life, depression, and weight loss.<ref name="Etiology, Diagnosis and Management" />

==Causes==
OMD can be acquired, inherited, or idiopathic. The clinical presentation of a more complicated degenerative [[movement disorder]] may include inherited OMD.<ref name="Pathophysiological mechanisms">{{cite journal | last=Manzo | first=Nicoletta | last2=Ginatempo | first2=Francesca | last3=Belvisi | first3=Daniele | last4=Defazio | first4=Giovanni | last5=Conte | first5=Antonella | last6=Deriu | first6=Franca | last7=Berardelli | first7=Alfredo | title=Pathophysiological mechanisms of oromandibular dystonia | journal=Clinical Neurophysiology | publisher=Elsevier BV | volume=134 | year=2022 | issn=1388-2457 | doi=10.1016/j.clinph.2021.11.075 | pages=73–80}}</ref> Patients with inherited focal OMD have also been documented to have dystonia type 6,<ref name="Lohmann Uflacker Erogullari Lohnau 2011 pp. 171–175">{{cite journal | last=Lohmann | first=Katja | last2=Uflacker | first2=Nils | last3=Erogullari | first3=Alev | last4=Lohnau | first4=Thora | last5=Winkler | first5=Susen | last6=Dendorfer | first6=Andreas | last7=Schneider | first7=Susanne A | last8=Osmanovic | first8=Alma | last9=Svetel | first9=Marina | last10=Ferbert | first10=Andreas | last11=Zittel | first11=Simone | last12=Kühn | first12=Andrea A | last13=Schmidt | first13=Alexander | last14=Altenmüller | first14=Eckart | last15=Münchau | first15=Alexander | last16=Kamm | first16=Christoph | last17=Wittstock | first17=Matthias | last18=Kupsch | first18=Andreas | last19=Moro | first19=Elena | last20=Volkmann | first20=Jens | last21=Kostic | first21=Vladimir | last22=Kaiser | first22=Frank J | last23=Klein | first23=Christine | last24=Brüggemann | first24=Norbert | title=Identification and functional analysis of novel THAP1 mutations | journal=European Journal of Human Genetics | publisher=Springer Science and Business Media LLC | volume=20 | issue=2 | date=August 17, 2011 | issn=1018-4813 | doi=10.1038/ejhg.2011.159 | pages=171–175}}</ref> dystonia type 4, and dystonia type 16.<ref name="Ma Qu Ye Shu 2021 p. ">{{cite journal | last=Ma | first=Hongying | last2=Qu | first2=Jian | last3=Ye | first3=Liangjun | last4=Shu | first4=Yi | last5=Qu | first5=Qiang | title=Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update | journal=Frontiers in Neurology | publisher=Frontiers Media SA | volume=12 | date=March 29, 2021 | issn=1664-2295 | doi=10.3389/fneur.2021.630221 | doi-access=free | page=}}</ref><ref name="Camargos Cardoso 2016 pp. 921–936">{{cite journal | last=Camargos | first=Sarah | last2=Cardoso | first2=Francisco | title=Understanding dystonia: diagnostic issues and how to overcome them | journal=Arquivos de Neuro-Psiquiatria | publisher=FapUNIFESP (SciELO) | volume=74 | issue=11 | year=2016 | issn=0004-282X | doi=10.1590/0004-282x20160140 | pages=921–936}}</ref> Medication-induced OMD is the most prevalent type of acquired OMD. Although there have been several reports of OMD cases following dental work, it is still unknown whether these procedures are linked to the onset of dystonic symptoms.<ref name="Thompson Obeso Delgado Gallego 1986 pp. 651–656">{{cite journal | last=Thompson | first=P D | last2=Obeso | first2=J A | last3=Delgado | first3=G | last4=Gallego | first4=J | last5=Marsden | first5=C D | title=Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm. | journal=Journal of Neurology, Neurosurgery &amp; Psychiatry | publisher=BMJ | volume=49 | issue=6 | date=June 1, 1986 | issn=0022-3050 | doi=10.1136/jnnp.49.6.651 | pages=651–656}}</ref><ref name="Jankovic Van der Linden 1988 pp. 1512–1519">{{cite journal | last=Jankovic | first=J | last2=Van der Linden | first2=C | title=Dystonia and tremor induced by peripheral trauma: predisposing factors. | journal=Journal of Neurology, Neurosurgery &amp; Psychiatry | publisher=BMJ | volume=51 | issue=12 | date=December 1, 1988 | issn=0022-3050 | doi=10.1136/jnnp.51.12.1512 | pages=1512–1519}}</ref> Similarly, it is unknown how much peripheral trauma<ref name="Defazio Fabbrini Erro Albanese 2020 pp. 40–43">{{cite journal | last=Defazio | first=Giovanni | last2=Fabbrini | first2=Giovanni | last3=Erro | first3=Roberto | last4=Albanese | first4=Alberto | last5=Barone | first5=Paolo | last6=Zibetti | first6=Maurizio | last7=Esposito | first7=Marcello | last8=Pellicciari | first8=Roberta | last9=Avanzino | first9=Laura | last10=Bono | first10=Francesco | last11=Eleopra | first11=Roberto | last12=Bertolasi | first12=Laura | last13=Altavista | first13=Maria Concetta | last14=Cotelli | first14=Maria Sofia | last15=Ceravolo | first15=Roberto | last16=Scaglione | first16=Cesa | last17=Bentivoglio | first17=Anna Rita | last18=Cossu | first18=Giovanni | last19=Coletti Moja | first19=Mario | last20=Girlanda | first20=Paolo | last21=Misceo | first21=Salvatore | last22=Pisani | first22=Antonio | last23=Mascia | first23=Marcello Mario | last24=Ercoli | first24=Tommaso | last25=Tinazzi | first25=Michele | last26=Maderna | first26=Luca | last27=Minafra | first27=Brigida | last28=Magistrelli | first28=Luca | last29=Romano | first29=Marcello | last30=Aguggia | first30=Marco | last31=Tambasco | first31=Nicola | last32=Castagna | first32=Anna | last33=Cassano | first33=Daniela | last34=Berardelli | first34=Alfredo | last35=Ferrazzano | first35=Gina | last36=Lalli | first36=Stefania | last37=Silvestre | first37=Francesco | last38=Manganelli | first38=Fiore | last39=Di Biasio | first39=Francesca | last40=Marchese | first40=Roberta | last41=Demonte | first41=Giulio | last42=Santangelo | first42=Domenico | last43=Devigili | first43=Grazia | last44=Durastanti | first44=Valentina | last45=Turla | first45=Marinella | last46=Mazzucchi | first46=Sonia | last47=Petracca | first47=Martina | last48=Oppo | first48=Valentina | last49=Barbero | first49=Pierangelo | last50=Morgante | first50=Francesca | last51=Di Lazzaro | first51=Giulia | last52=Squintani | first52=Giovanna | last53=Modugno | first53=Nicola | title=Does acute peripheral trauma contribute to idiopathic adult-onset dystonia? | journal=Parkinsonism &amp; Related Disorders | publisher=Elsevier BV | volume=71 | year=2020 | issn=1353-8020 | doi=10.1016/j.parkreldis.2020.01.002 | pages=40–43}}</ref><ref name="Molloy Kimmich Williams Butler 2014 pp. 331–335">{{cite journal | last=Molloy | first=A. | last2=Kimmich | first2=O. | last3=Williams | first3=L. | last4=Butler | first4=J. S. | last5=Byrne | first5=N. | last6=Molloy | first6=F. | last7=Moore | first7=H. | last8=Healy | first8=D. G. | last9=Lynch | first9=T. | last10=Edwards | first10=M. J. | last11=Walsh | first11=C. | last12=Reilly | first12=R. B. | last13=O'Riordan | first13=S. | last14=Hutchinson | first14=M. | title=An evaluation of the role of environmental factors in the disease penetrance of cervical dystonia | journal=Journal of Neurology, Neurosurgery &amp; Psychiatry | publisher=BMJ | volume=86 | issue=3 | date=June 24, 2014 | issn=0022-3050 | doi=10.1136/jnnp-2014-307699 | pages=331–335}}</ref> contributes to OMD risk.<ref name="Sankhla Lai Jankovic 1998 pp. 722–728">{{cite journal | last=Sankhla | first=C. | last2=Lai | first2=E. C | last3=Jankovic | first3=J. | title=Peripherally induced oromandibular dystonia | journal=Journal of Neurology, Neurosurgery &amp; Psychiatry | publisher=BMJ | volume=65 | issue=5 | date=November 1, 1998 | issn=0022-3050 | doi=10.1136/jnnp.65.5.722 | pages=722–728}}</ref><ref name="Raoofi Khorshidi Najafi p. ">{{cite journal | last=Raoofi | first=Saeed | last2=Khorshidi | first2=Hooman | last3=Najafi | first3=Maryam | title=Etiology, Diagnosis and Management of Oromandibular Dystonia: an Update for Stomatologists | journal=Journal of Dentistry | publisher=Shiraz University of Medical Sciences | volume=18 | issue=2 | pmid=28620630 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463774/ | access-date=January 18, 2024 | page=}}</ref><ref name="Jang Cho Sung Kim 2012 p. 379">{{cite journal | last=Jang | first=Soo-Mi | last2=Cho | first2=Yeong-Cheol | last3=Sung | first3=Iel-Yong | last4=Kim | first4=Sun-Young | last5=Son | first5=Jang-Ho | title=Oromandibular dystonia after dental treatments: a report of two cases | journal=Journal of the Korean Association of Oral and Maxillofacial Surgeons | publisher=The Korean Association of Oral and Maxillofacial Surgeons | volume=38 | issue=6 | year=2012 | issn=2234-7550 | doi=10.5125/jkaoms.2012.38.6.379 | page=379}}</ref>

==Diagnosis==
Because OMD can manifest in a variety of ways and to varying degrees, diagnosing it is a clinical and challenging process. Since there is no medical test that can diagnose it, the diagnosis is made based on the patient's medical history, physical examination, neurological examination, and intramuscular [[electromyography]] (EMG) confirmation.<ref name="Etiology, Diagnosis and Management" />

Hemifacial spasm, psychological disorders, and [[Temporomandibular joint dysfunction|TMJ disorders]] (such as [[bruxism]] or spontaneous condylar dislocation) are included in the differential diagnosis.<ref name="Etiology, Diagnosis and Management" />

==Treatment==
The effectiveness of the different medications currently used to treat [[dystonia]] is not well-documented.<ref name="Jinnah Teller Galpern 2015 pp. 400–405">{{cite journal | last=Jinnah | first=Hyder A. | last2=Teller | first2=Jan K. | last3=Galpern | first3=Wendy R. | title=Recent developments in dystonia | journal=Current Opinion in Neurology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=28 | issue=4 | year=2015 | issn=1350-7540 | doi=10.1097/wco.0000000000000213 | pages=400–405}}</ref> Nonetheless, [[lithium]], [[L-DOPA|levodopa]], [[Dopamine antagonist|dopamine receptor antagonists]], [[carbamazepine]], [[Anticonvulsant|anticonvulsants]], [[Antiparkinson drug|antiparkinson drugs]], [[Benzodiazepine|benzodiazepines]], [[baclofen]], and [[anticholinergic]] are a few of the medications used to treat OMD.<ref name="Jinnah Factor 2015 pp. 77–100">{{cite journal | last=Jinnah | first=H.A. | last2=Factor | first2=Stewart A. | title=Diagnosis and Treatment of Dystonia | journal=Neurologic Clinics | publisher=Elsevier BV | volume=33 | issue=1 | year=2015 | issn=0733-8619 | doi=10.1016/j.ncl.2014.09.002 | pages=77–100}}</ref>

It is believed that over time, [[Physical therapy|physiotherapy]] will encourage brain rewiring, which will lessen dystonic movements. This response is widely recognized among musicians.<ref>{{cite journal |last1=Thorburn |first1=D N |last2=Lee |first2=K H |title=Oromandibular dystonia following dental treatment: case reports and discussion |journal=The New Zealand dental journal |date=March 2009 |volume=105 |issue=1 |pages=18–21 |pmid=19418679}}</ref>

Injections of [[Botulinum neurotoxin|botulinum neurotoxins]] (BoNT), a potent [[neurotoxin]] that inhibits [[acetylcholine]] release at the presynaptic junction and causes transient chemical denervation of skeletal muscles, are a promising treatment for OMD.<ref name="Etiology, Diagnosis and Management" />

==Epidemiology==
OMD is thought to affect 68.9 cases per million people.<ref name="Nutt Muenter Aronson Kurland 1988 pp. 188–194">{{cite journal | last=Nutt | first=John G. | last2=Muenter | first2=Manfred D. | last3=Aronson | first3=Arnold | last4=Kurland | first4=Leonard T. | last5=Melton | first5=L. Joseph | title=Epidemiology of focal and generalized dystonia in Rochester, Minnesota | journal=Movement Disorders | publisher=Wiley | volume=3 | issue=3 | year=1988 | issn=0885-3185 | doi=10.1002/mds.870030302 | pages=188–194}}</ref> OMD typically manifests itself during the sixth decade of life.<ref name="Slaim Cohen Klap Vidailhet 2018 pp. 78–81">{{cite journal | last=Slaim | first=Linda | last2=Cohen | first2=Myriam | last3=Klap | first3=Patrick | last4=Vidailhet | first4=Marie | last5=Perrin | first5=Alain | last6=Brasnu | first6=Daniel | last7=Ayache | first7=Denis | last8=Mailly | first8=Marie | title=Oromandibular Dystonia: Demographics and Clinical Data from 240 Patients | journal=Journal of Movement Disorders | publisher=The Korean Movement Disorder Society | volume=11 | issue=2 | date=May 25, 2018 | issn=2005-940X | doi=10.14802/jmd.17065 | pages=78–81}}</ref> Almost twice as many women as men are impacted.<ref name="Ovid Technologies (Wolters Kluwer Health) 1999 pp. 1871–1871">{{cite journal | title=Sex-related influences on the frequency and age of onset of primary dystonia | journal=Neurology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=53 | issue=8 | year=1999 | issn=0028-3878 | doi=10.1212/wnl.53.8.1871 | pages=1871–1871}}</ref>


==References==
==References==
{{reflist}}
{{reflist}}

==Further reading==
* {{cite journal | last=Krishnan | first=Syam | last2=Saraf | first2=Udit | last3=Chandarana | first3=Mitesh | last4=Divya | first4=KP | title=Oromandibular dystonia&nbsp;– A systematic review | journal=Annals of Indian Academy of Neurology | publisher=Medknow | volume=25 | issue=1 | year=2022 | issn=0972-2327 | doi=10.4103/aian.aian_242_21 | doi-access=free | page=26 | ref=none}}
* {{cite journal | last=Tan | first=Eng-King | last2=Jankovic | first2=Joseph | title=Botulinum toxin A in patients with oromandibular dystonia | journal=Neurology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=53 | issue=9 | year=1999 | issn=0028-3878 | doi=10.1212/wnl.53.9.2102 | pages=2102–2102 | ref=none}}

==External links==
* [https://dystonia-foundation.org/what-is-dystonia/types-dystonia/oromandibular/ Dystonia Medical Research Foundation]
* [https://www.colgate.com/en-us/oral-health/developmental-disabilities/what-is-oromandibular-dystonia Colgate]

{{Medical resources
| ICD11 = {{ICD11|8A02.0Y}}
| ICD10 = {{ICD10|G24.8}}
| ICD10CM = <!-- {{ICD10CM|Xxx.xxxx}} -->
| ICD9 = <!-- {{ICD9|xxx}} -->
| ICDO =
| OMIM =
| MeshID =
| DiseasesDB =
| SNOMED CT = 230328001
| Curlie =
| MedlinePlus =
| eMedicineSubj =
| eMedicineTopic =
| PatientUK =
| NCI =
| GeneReviewsNBK =
| GeneReviewsName =
| NORD =
| GARDNum =
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| RP =
| AO =
| WO =
| OrthoInfo =
| Orphanet =
| Scholia = Q73828
| OB =
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{{Central nervous system disease}}
{{Central nervous system disease}}

Revision as of 04:44, 18 January 2024

Oromandibular dystonia
Other namesOrofaciomandibular dystonia, lingual dystonia, orofacial buccal dystonia, jaw dystonia, adult onset facial dystonia, and cranial dystonia.
SpecialtyNeurology Edit this on Wikidata

Oromandibular dystonia (OMD) is an uncommon focal neurological condition affecting the jaws, face, and mouth.[1] Oromandibular dystonia is characterized by involuntary spasms of the tongue, jaw, and mouth muscles that result in bruxism, or grinding of the teeth, and jaw closure. These conditions frequently lead to secondary dental wear as well as temporomandibular joint syndrome. In addition, problems with chewing, speaking, and swallowing may result from jaw opening, involuntary tongue movements, or jaw deviation.[2]

Meige's syndrome is the combination of upper facial dystonic movements, blepharospasm, and OMD.[3]

While the use of oral appliances has been documented, effective management typically consists of a combination of physiotherapy, oral medications, and botulinum toxin injections.[4]

Signs and symptoms

Clinical manifestations vary depending on the muscles involved, the extent of OMD, and its distribution.[5] Impaired mastication, dysphagia, dysphonia (alteration of speech), mandibular disorders (TMD) such as open locks, unconscious mandibular opening and closing, and pulling and twisting of the mandible forward or laterally are examples of dysfunctions.[6][7]

Indications of dystonic spasms include platysma spasms, mouth corner retractions, tongue dyskinesia, bruxism, lip pursing or sucking, facial grimacing, and nasal contractions.[1] Breathing issues or dysarthria are also infrequently reported.[8]

The onset of symptoms is more common in women and typically occurs between the ages of 40 and 70. The symptoms only show up when speaking or masticating, for example.[1] Typically, patients list stress, talking, chewing, praying, and chewing objects as triggers.[9] Routine lab tests are typically normal.[6] Most of the time, it is reported that poor oral function is linked to social embarrassment, a lower quality of life, depression, and weight loss.[1]

Causes

OMD can be acquired, inherited, or idiopathic. The clinical presentation of a more complicated degenerative movement disorder may include inherited OMD.[10] Patients with inherited focal OMD have also been documented to have dystonia type 6,[11] dystonia type 4, and dystonia type 16.[12][13] Medication-induced OMD is the most prevalent type of acquired OMD. Although there have been several reports of OMD cases following dental work, it is still unknown whether these procedures are linked to the onset of dystonic symptoms.[14][15] Similarly, it is unknown how much peripheral trauma[16][17] contributes to OMD risk.[18][19][20]

Diagnosis

Because OMD can manifest in a variety of ways and to varying degrees, diagnosing it is a clinical and challenging process. Since there is no medical test that can diagnose it, the diagnosis is made based on the patient's medical history, physical examination, neurological examination, and intramuscular electromyography (EMG) confirmation.[1]

Hemifacial spasm, psychological disorders, and TMJ disorders (such as bruxism or spontaneous condylar dislocation) are included in the differential diagnosis.[1]

Treatment

The effectiveness of the different medications currently used to treat dystonia is not well-documented.[21] Nonetheless, lithium, levodopa, dopamine receptor antagonists, carbamazepine, anticonvulsants, antiparkinson drugs, benzodiazepines, baclofen, and anticholinergic are a few of the medications used to treat OMD.[22]

It is believed that over time, physiotherapy will encourage brain rewiring, which will lessen dystonic movements. This response is widely recognized among musicians.[23]

Injections of botulinum neurotoxins (BoNT), a potent neurotoxin that inhibits acetylcholine release at the presynaptic junction and causes transient chemical denervation of skeletal muscles, are a promising treatment for OMD.[1]

Epidemiology

OMD is thought to affect 68.9 cases per million people.[24] OMD typically manifests itself during the sixth decade of life.[25] Almost twice as many women as men are impacted.[26]

References

  1. ^ a b c d e f g Raoofi, Saeed; Khorshidi, Hooman; Najafi, Maryam. "Etiology, Diagnosis and Management of Oromandibular Dystonia: an Update for Stomatologists". Journal of Dentistry. 18 (2). Shiraz University of Medical Sciences. PMID 28620630. Retrieved January 18, 2024.
  2. ^ Jankovic, Joseph (2003). "Primary and Secondary Generalized Dystonias". Office Practice of Neurology. Elsevier. p. 816–821. doi:10.1016/b0-44-306557-8/50130-1.
  3. ^ Pandey, Sanjay; Sharma, Soumya (2017). "Meige's syndrome: History, epidemiology, clinical features, pathogenesis and treatment". Journal of the Neurological Sciences. 372. Elsevier BV: 162–170. doi:10.1016/j.jns.2016.11.053. ISSN 0022-510X.
  4. ^ Watt, Eileen; Sangani, Indiya; Crawford, Fiona; Gillgrass, Toby (2013-12-02). "The role of a dentist in managing patients with dystonia". Dental Update. 40 (10): 846–848. doi:10.12968/denu.2013.40.10.846. ISSN 0305-5000.
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Further reading

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