Presentation
In some patients the R1 component was also present on the side contralateral to the stimulus, while in normal subjects it was present only on the ipsilateral side. [ncbi.nlm.nih.gov]
Some patients presenting OMD subsequent to focal radiotherapy may have a genetic susceptibility, given that many more patients do not; this topic requires further clarification. [elsevier.es]
Case 5 A 56-year-old female presented with a chief complaint of involuntary jaw movements. [head-face-med.biomedcentral.com]
Entire Body System
- Weakness
A 32 years female presented with gradually progressive dysarthria, dysphagia, oromandibular dystonia and mild generalized weakness. She had several episodes of acute psychotic behavior. [ncbi.nlm.nih.gov]
Preliminary analyses revealed adverse effects in 9, mainly mild, and included dysphagia(6), voice change(5), soft palate weakness(4). [mdsabstracts.org]
This disrupts ACH release and subsequent neuromuscular transmission, resulting in weakness of the injected muscle. [emedicine.medscape.com]
Side effects of this treatment may include difficulty swallowing, slurred speech and weakness, but they are short-term and well-tolerated. [ic.steadyhealth.com]
Use of botulinum toxin has been reported to be occasionally effective in the treatment of lingual dystonia; however, side effects such as swallowing difficulties, speech problems, and excessive muscle weakness where the injection was placed have been [medicine.uiowa.edu]
- Fatigue
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 14, 2019 [patientslikeme.com]
Symptoms may interfere with eating and drinking, and fatigue is common due to the exertion required to speak or maintain positioning of the jaw. Individuals may have to learn new ways to accomplish daily tasks. [dystoniacanada.org]
Early symptoms of dystonia can initially be small occurrences that materialize only after sustained fatigue, stress or physical exertion: involuntary rapid eye blinking or spasms that close the eye dragging, turning or cramping of the foot neck pulling [nspc.com]
Some early symptoms include: A "dragging leg" Cramping of the foot Involuntary pulling of the neck Uncontrollable blinking Speech difficulties Stress or fatigue may bring on the symptoms or cause them to worsen. [webmd.com]
Cramping of the hand during writing or fatigue during walking or other manual activities may indicate limb dystonia. Dystonia is also variable in its progression. For some patients, the disease steadily worsens; for others, it plateaus. [aans.org]
- Asymptomatic
Thirdly, CD patients may have adapted to changes in swallowing function and therefore be asymptomatic [ 7 ]. [intechopen.com]
- Anemia
[…] salivary gland function 0.5ml/min, oral dryness The climacteric Undiagnosed diabetes Glucose Psychological Cattell’s 16PF questionnaire Income-$19999 or less No limitations in ADL None taking prescribed medications Replacement of amalgam Blood test Anemia [seesaawiki.jp]
Gastrointestinal
- Dyspepsia
The most common side effects of sertraline are sleepiness, nervousness, increased sweating somnolence, insomnia, dizziness, nausea, tremor, skin rash, dyspepsia, loss of appetite, headache, diarrhea, abnormal ejaculation, dry mouth and weight loss. [scopemed.org]
Cardiovascular
- Hypertension
Defazio G et al. (2000) Primary hemifacial spasm and arterial hypertension: a multicenter case–control study. Neurology 54 : 1198–1200 63. Colosimo C et al. (2003) Is hypertension associated with hemifacial spasm. Neurology 61 : 587 64. [nature.com]
Her medical history revealed hypertension and diabetes mellitus. Her medication history was unremarkable for dystonia. [tremorjournal.org]
Musculoskeletal
- Torticollis
Torticollis or dystonic writer's camp preceded the syndrome in two patients. Eight other patients developed toritocollis, dystonic posturing of the arms, or involvement of respiratory muscles. [ncbi.nlm.nih.gov]
[…] excluding Akathisia/Restlessness Akathisia 5 11 Dystonia* 1 1 Parkinsonism** 8 13 Restlessness 1 4 Note: Figures rounded to the nearest integer *Dystonia includes adverse event terms: dystonia, oculogyric crisis, oromandibular dystonia, tongue spasm, torticollis [medical-dictionary.thefreedictionary.com]
Benign Essential Blepharospasm Research Foundation (BEBRF), Texas USA National Spasmodic Dysphonia Association, Chicago USA National Spasmodic Torticollis Association, California USA Spasmodic Torticollis/Dystonia Inc (WI, USA) Bachmann-Strauss Dystonia [brainfoundation.org.au]
Botulinum toxin can virtually eliminate the jerky posturing of the head in torticollis or the eye spasms in blepharospasm. [hopkinsmedicine.org]
The head may tilt (laterocollis) or twist to one side (rotational torticollis), forward (anterocollis) or backward (retrocollis). The movements may be sustained or jerky (myoclonic torticollis). [netdoctor.co.uk]
Eyes
- Blurred Vision
Side effects of anticholinergics include: dry mouth constipation difficulties urinating blurred vision memory problems confusion Baclofen Baclofen is a medication that's sometimes used to treat spasticity (excessive muscular tension) caused by stroke [nhsinform.scot]
Side-effects include dry mouth, blurred vision, constipation, difficulty in urinating, memory impairment or confusion. But your doctor will increase the dosage slowly to reduce the chance of side-effects. [netdoctor.co.uk]
Psychiatrical
- Psychomotor Retardation
retardation, tongue spasm, torticollis, tremor, and trismus. [medical-dictionary.thefreedictionary.com]
Neurologic
- Dystonia
[…] in the literature is scarce but it does link dystonias to radiotherapy. [elsevier.es]
OBJECTIVE: Most patients with tardive dystonia have a focal onset involving the cranial-cervical region. Because of its resemblance to idiopathic cranial dystonia, a common form of dystonia, it often poses a diagnostic problem. [ncbi.nlm.nih.gov]
One patient (6) had pre-existing cervical dystonia and had received haloperidol as a treatment for her cervical dystonia. [dx.doi.org]
- Tremor
KEYWORDS: Botulinum toxin; Jaw tremor; Lingual dystonia; Oromandibular dystonia; Quality of life [ncbi.nlm.nih.gov]
[…] tongue spasm, torticollis, and trismus **Parkinsonism includes adverse event terms: bradykinesia, cogwheel rigidity, drooling, extrapyramidal disorder, glabellar reflex abnormal, hypokinesia, muscle rigidity, parkinsonism, psychomotor retardation, and tremor [medical-dictionary.thefreedictionary.com]
Two patients (1 and 27) had essential tremor, two (1 and 24) had a positive family history of essential tremor, and one had associated tics consistent with the diagnosis of Tourette’s syndrome. [dx.doi.org]
- Dysarthria
Results: Dysarthria was the most common disorder and its characteristics varied from one patient to another. [ncbi.nlm.nih.gov]
Results Dysarthria was the most common disorder and its characteristics varied from one patient to another. [jslhr.pubs.asha.org]
Frequently, jaw-opening OMD is less responsive than jaw-closing, and it is more likely to be associated with dysphagia and dysarthria 13-16. [scielo.br]
Dysphagia and dysarthria (which account for 10.2 % to 37 % and 0.9 % of complaints, respectively) are the two most common adverse effects of BoNT treatment for OMD [ 37, 42 ]. [intechopen.com]
Workup
Workup Patients should be evaluated for a family history of dystonia or the presence of other dystonias. [entokey.com]
Treatment
Oral agents remain one of the first-line medical treatments for OMD, and evaluation by a neurologist for consideration of such treatment is a prudent initial step. [entokey.com]
Botulinum type A toxin is an effective treatment of oromandibular dystonia. It is important for clinicians to recognise the condition, as treatment is well-tolerated and can improve quality of life. [ncbi.nlm.nih.gov]
Prognosis
The prognosis is poor and the treatment is symptomatic. This paper describes a case of a 38-year-old woman referred for a locked left TMJ who was diagnosed as having an oromandibular dystonia. [ncbi.nlm.nih.gov]
It is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor. [dystonia.org.uk]
Dr Salah Omer gave a lecture on Progressive Myoclonic Epilepsy, and Dr Bridget Mcdonald adressed the questions of the long term prognosis of cerebral palsy. I gave a lecture on the contribution of Botulinum toxin to Neurology over the last 25 years. [infodystonia.com]
Types of dystonia: The many types of dystonia are divided into separate groups because of their implications for treatment and prognosis. [hopkinsmedicine.org]
Prognosis What is my prognosis? If dystonia develops in childhood, particularly if it starts in the legs, then in many (but not all) cases it will spread to other parts of the body and become generalised. [brainfoundation.org.au]
Etiology
Clinical characteristics, etiology of brain injury, and pattern of dystonia were analyzed. Patients with clinically significant CD and OMD were treated with BTx and followed for 12 weeks. [ncbi.nlm.nih.gov]
By definition, all cases of "dystonia plus" are secondary, although the etiology (eg, neuroleptics, Wilson disease, neuroacanthocytosis, trauma) may not always be obvious. [medlink.com]
Differential diagnosis of oromandibular dystonia and various etiologies were investigated. Neuroimaging studies revealed a left cerebellar infarction. [academiccommons.columbia.edu]
The etiology is unknown but in the idiopathic form is believed to be related to a neurotransmitter defect possible in the basal ganglia. About 20% of patients with brain injuries develop new onset cervical or oromandibular dystonias. [mussenhealth.us]
Epidemiology
These results may be of value with regard to the conduct of multicenter epidemiologic and clinical studies on focal dystonias. [ncbi.nlm.nih.gov]
Epidemiology of focal and generalized dystonia in Rochester, Minnesota. Mov Disord 1988; 3: 188-194. 14. Giron L T, Koller W, Tanner C M. Epidemiology of dystonic disorders. En: Tsui J K, Calne D (eds). Hanbook of Dystonia. Nueva York. [svneurologia.org]
Epidemiology, clinical features, and etiology Oromandibular dystonia affects women more frequently than men and the prevalence was estimated to be 68.9 cases per 1 million Americans (for reviews see Bhidayasiri et al. [2006]). [cambridge.org]
Defazio G et al. (2004) Epidemiology of primary dystonia. Lancet Neurol 3 : 673–678 7. Defazio G et al. (2007) Do primary adult-onset focal dystonias share aetiological factors? Brain 130 : 1183–1193 8. [nature.com]
: Epidemiology in focal and generalized dystonia in Rochester, Minnesota. Movement Disorders 3:188–194, 1988. CrossRef PubMed Google Scholar [18] Powers J.M. : Blepharospam due to unilateral diencephalon infarction. Neurology 35:283–284, 1985. [link.springer.com]
Pathophysiology
The effect of cholinergic agents was less than the effect of dopaminergic drugs, implying that dopamine plays a predominant role in the pathophysiology. [ncbi.nlm.nih.gov]
Possible roles of the cerebellum for the pathophysiology of oromandibular dystonia are discussed. Keywords: Dystonia, oromandibular dystonia, cerebrovascular disease Citation: Akin A, Yilmaz R, Selcuk F, et al. [academiccommons.columbia.edu]
Cruccu G et al. (1994) Pathophysiology of hemimasticatory spasm. J Neurol Neurosurg Psychiatry 57 : 43–50 81. [nature.com]
In the last 10 years, authors have published several cases of patients with focal dystonia related to peripheral trauma and provided lists of possible pathophysiological mechanisms for this type of dystonia. 6 To the best of our knowledge, information [elsevier.es]
Prevention
In the present case history, treatment for OMD was started as soon as the diagnosis of jaw-closing OMD was established, and dental treatment intervention for preventing its development or progression was considered at the same time. [ncbi.nlm.nih.gov]
It prevents specific neurotransmitters from reaching the affected muscles, preventing spasms. Botulinum toxin is administered by injection. One dose usually lasts about 3 months. There may be some initial (temporary) pain at the injection site. [medicalnewstoday.com]
Therefore, to prevent these and other complications, prompt and appropriate treatment of OMD is important. [dx.doi.org]