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Chapter 10 - Botulinum Neurotoxin in Oromandibular Dystonia

Published online by Cambridge University Press:  02 November 2023

By
Roongroj Bhidayasiri ,
Suppata Maytharakcheep  and
Daniel Truong
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Oromandibular dystonia (OMD) is a form of focal dystonia that involves the masticatory, lower facial, labial and lingual musculature affected by the trigeminal, facial and hypoglossal cranial nerves. OMD can be classified into various subtypes, which include jaw-opening, jaw-closing, jaw-deviating, lingual, perioral and/or pharyngeal dystonia. Dystonic spasms may result in clenching, or trismus; grinding of the teeth, or bruxism; tongue thrusting; lip pursing; and other movements.

Evidence-based reviews and clinical experience strongly regard botulinum neurotoxin (BoNT) injection as the first-line treatment for OMD. Patients with OMD require careful examination to determine the particular muscles involved and their pattern of contraction to enable proper selection and targeting for BoNT injection. This chapter enumerates the particular muscles involved in each subtype of OMD, discusses localization and approach for injection and use of guidance techniques where applicable, and tabulates typical dose ranges for different formulations of BoNT. Typical adverse events and techniques to avoid them are discussed.

Keywords

Oromandibular dystoniaMeige syndromejaw clenchingjaw openinglingual dystoniaperioral dystoniapharyngeal dystoniatrismusbruxismbotulinum neurotoxinBoNT
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 73 - 81
Publisher: Cambridge University Press
Print publication year: 2023

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References

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